Provider Demographics
NPI:1134157407
Name:PITA, JULIO C JR (MD)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:C
Last Name:PITA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6705 RED ROAD
Mailing Address - Street 2:SUITE 714
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3652
Mailing Address - Country:US
Mailing Address - Phone:305-662-1160
Mailing Address - Fax:305-662-1159
Practice Address - Street 1:6705 SW 57TH AVE STE 714
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3652
Practice Address - Country:US
Practice Address - Phone:305-662-1160
Practice Address - Fax:305-662-1159
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2024-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME21364207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057915700Medicaid
FLD60138Medicare UPIN
FL057915700Medicaid