Provider Demographics
NPI:1992862726
Name:JULIO'S PHARMACY INC
Entity Type:Organization
Organization Name:JULIO'S PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONI D
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOBODSKOY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:305-884-0703
Mailing Address - Street 1:2875 W 2ND AVENUE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010
Mailing Address - Country:US
Mailing Address - Phone:305-884-0703
Mailing Address - Fax:305-884-9903
Practice Address - Street 1:2875 W 2ND AVENUE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010
Practice Address - Country:US
Practice Address - Phone:305-884-0703
Practice Address - Fax:305-884-9903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPH 116673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024716800Medicaid