Provider Demographics
NPI:1295707255
Name:RAYMAKER, JULIANA A (MD)
Entity type:Individual
Prefix:DR
First Name:JULIANA
Middle Name:A
Last Name:RAYMAKER
Suffix:
Gender:F
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:PO BOX 3266
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32085-3266
Mailing Address - Country:US
Mailing Address - Phone:904-819-4206
Mailing Address - Fax:904-819-4426
Practice Address - Street 1:1000 UNIVERSAL STUDIOS PLZ BLDG 3
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7601
Practice Address - Country:US
Practice Address - Phone:407-355-0803
Practice Address - Fax:407-355-0432
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100786207Q00000X
FL100786207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009428400Medicaid
FLP01391239OtherRAILROAD MEDICARE
FLAK993WMedicare PIN
FLP01391239OtherRAILROAD MEDICARE
FL009428400Medicaid