Provider Demographics
NPI:1649206129
Name:CRONAUER, JULIE M (OD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:CRONAUER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326
Mailing Address - Country:US
Mailing Address - Phone:954-384-0266
Mailing Address - Fax:954-384-6268
Practice Address - Street 1:1673 MARKET ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326
Practice Address - Country:US
Practice Address - Phone:954-384-0266
Practice Address - Fax:954-384-6268
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0001630152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19381T93877Medicare ID - Type Unspecified