Provider Demographics
NPI:1538516174
Name:GEORGES-LOUIS, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GEORGES-LOUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 BOOT BAY RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-1336
Mailing Address - Country:US
Mailing Address - Phone:813-717-7778
Mailing Address - Fax:813-717-7778
Practice Address - Street 1:3912 BOOT BAY RD
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-1336
Practice Address - Country:US
Practice Address - Phone:813-717-7778
Practice Address - Fax:813-717-7778
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker