Provider Demographics
NPI:1689813537
Name:PERON, JULLIETTE ANNE (ARNP)
Entity Type:Individual
Prefix:
First Name:JULLIETTE
Middle Name:ANNE
Last Name:PERON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5118 TARI STREAM WAY
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8418
Mailing Address - Country:US
Mailing Address - Phone:813-857-4614
Mailing Address - Fax:
Practice Address - Street 1:111 NORTH BREVARD AVENUE
Practice Address - Street 2:DICKEY HEALTH AND WELLNESS
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3360
Practice Address - Country:US
Practice Address - Phone:813-253-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9215068363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health