Provider Demographics
NPI:1922628049
Name:LEAVY, JULIA R (AP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:R
Last Name:LEAVY
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4200
Mailing Address - Country:US
Mailing Address - Phone:352-225-1231
Mailing Address - Fax:
Practice Address - Street 1:1309 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4200
Practice Address - Country:US
Practice Address - Phone:352-225-1231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-18
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3705171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist