Provider Demographics
NPI:1851743587
Name:JULIAN, ELYSE (DO)
Entity Type:Individual
Prefix:DR
First Name:ELYSE
Middle Name:
Last Name:JULIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NW 70TH AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2364
Mailing Address - Country:US
Mailing Address - Phone:954-371-2208
Mailing Address - Fax:954-405-8802
Practice Address - Street 1:333 NW 70TH AVE STE 116
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2364
Practice Address - Country:US
Practice Address - Phone:954-371-2208
Practice Address - Fax:954-405-8802
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO5205207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology