Provider Demographics
NPI:1578946430
Name:LABARGE, JULIA N (AP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:N
Last Name:LABARGE
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3352 S SEMORAN BLVD
Mailing Address - Street 2:APT 11
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-2536
Mailing Address - Country:US
Mailing Address - Phone:321-437-5917
Mailing Address - Fax:
Practice Address - Street 1:3352 S SEMORAN BLVD
Practice Address - Street 2:APT 11
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-2536
Practice Address - Country:US
Practice Address - Phone:321-437-5917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3605171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist