Provider Demographics
NPI:1578202594
Name:DA SILVA, JULIANA (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:DA SILVA
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4684 EUCALYPTUS WAY
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-6415
Mailing Address - Country:US
Mailing Address - Phone:954-806-7908
Mailing Address - Fax:
Practice Address - Street 1:5461 MERIDIAN MARK RD STE 130
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3009
Practice Address - Country:US
Practice Address - Phone:404-255-2033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA297861207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric OtolaryngologyGroup - Single Specialty