Provider Demographics
NPI:1013938331
Name:JAVIER, JULIAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:J
Last Name:JAVIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 2ND AVE N
Mailing Address - Street 2:#100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5753
Mailing Address - Country:US
Mailing Address - Phone:239-300-0586
Mailing Address - Fax:239-300-0588
Practice Address - Street 1:680 2ND AVE N
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5753
Practice Address - Country:US
Practice Address - Phone:239-300-0586
Practice Address - Fax:239-300-0588
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70724207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42630OtherBCBS
FL202547273OtherTAX ID
FL42630WMedicare PIN
FL42630OtherBCBS