Provider Demographics
NPI:1023092525
Name:STAATS, JULIE ANNE (DO)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNE
Last Name:STAATS
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 1:2600 PARTIN DR N
Mailing Address - Street 2:STE 120
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-1543
Mailing Address - Country:US
Mailing Address - Phone:850-279-3040
Mailing Address - Fax:
Practice Address - Street 1:2600 PARTIN DR N
Practice Address - Street 2:STE 120
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-1543
Practice Address - Country:US
Practice Address - Phone:850-279-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-561207Q00000X
FLOS12516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine