Provider Demographics
NPI:1659832731
Name:JULIENNE SEIDE
Entity Type:Organization
Organization Name:JULIENNE SEIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDE
Authorized Official - Suffix:
Authorized Official - Credentials:CHAUFFEUR
Authorized Official - Phone:754-422-7083
Mailing Address - Street 1:2111 NW 55TH AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-3262
Mailing Address - Country:US
Mailing Address - Phone:754-422-7083
Mailing Address - Fax:
Practice Address - Street 1:2111 NW 55TH AVE APT 307
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-3262
Practice Address - Country:US
Practice Address - Phone:754-422-7083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No251V00000XAgenciesVoluntary or Charitable
No335G00000XSuppliersMedical Foods Supplier
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker