Provider Demographics
NPI:1568485076
Name:DANIELS, JULIUS E (LMT, RN)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:E
Last Name:DANIELS
Suffix:
Gender:M
Credentials:LMT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 PICKFORD PL
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4361
Mailing Address - Country:US
Mailing Address - Phone:850-261-3757
Mailing Address - Fax:
Practice Address - Street 1:3050 PICKFORD PL
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4361
Practice Address - Country:US
Practice Address - Phone:850-261-3757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA27732225700000X
FLRN9327458163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC8745OtherBLUE SHIELD OF FLORIDA