Provider Demographics
NPI:1245375633
Name:STUBER, JULIE ANN (DC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:STUBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:STUBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1530 CELEBRATION BLVD
Mailing Address - Street 2:SUITE 407
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5164
Mailing Address - Country:US
Mailing Address - Phone:407-566-9814
Mailing Address - Fax:407-566-9812
Practice Address - Street 1:1530 CELEBRATION BLVD
Practice Address - Street 2:SUITE 407
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5164
Practice Address - Country:US
Practice Address - Phone:407-566-9814
Practice Address - Fax:407-566-9812
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22591Medicare ID - Type Unspecified
FLU11081Medicare UPIN