Provider Demographics
NPI:1760969513
Name:PRETE, JULIANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:PRETE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 S. BABCOCK ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1459
Mailing Address - Country:US
Mailing Address - Phone:321-951-1010
Mailing Address - Fax:321-952-4038
Practice Address - Street 1:5200 BABCOCK ST NE
Practice Address - Street 2:SUITE 106
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4639
Practice Address - Country:US
Practice Address - Phone:321-729-9306
Practice Address - Fax:321-729-8050
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA207QA0505X
FLPA9111209363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine