Provider Demographics
NPI:1497018006
Name:NEMIROFF, JULIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:NEMIROFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 RCA BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3337
Mailing Address - Country:US
Mailing Address - Phone:561-331-1797
Mailing Address - Fax:561-331-5073
Practice Address - Street 1:2560 RCA BLVD STE 112
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3337
Practice Address - Country:US
Practice Address - Phone:561-331-1797
Practice Address - Fax:561-331-1797
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131906207W00000X, 207WX0107X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102676900Medicaid