Provider Demographics
NPI:1508816034
Name:CAMERON, JULIAN A (MD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:A
Last Name:CAMERON
Suffix:
Gender:M
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:PO BOX 17047
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318-7047
Mailing Address - Country:US
Mailing Address - Phone:954-747-1221
Mailing Address - Fax:954-747-1231
Practice Address - Street 1:7710 NW 71ST CT
Practice Address - Street 2:SUITE 205
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2973
Practice Address - Country:US
Practice Address - Phone:954-747-1221
Practice Address - Fax:954-747-1231
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063521207X00000X
FLME98523207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409527800Medicaid
MD409527800Medicaid
FLAI908Medicare UPIN
FLAI908Medicare UPIN