Provider Demographics
NPI:1922266154
Name:ORDONIO, JULEP PALOMARES
Entity Type:Individual
Prefix:
First Name:JULEP
Middle Name:PALOMARES
Last Name:ORDONIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14708 VIA SORRENTO DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3376
Mailing Address - Country:US
Mailing Address - Phone:954-242-0289
Mailing Address - Fax:
Practice Address - Street 1:14708 VIA SORRENTO DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3376
Practice Address - Country:US
Practice Address - Phone:954-242-0289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist