Provider Demographics
NPI:1396719449
Name:MCQUIRTER, JULIAN A (MD)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:A
Last Name:MCQUIRTER
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 1:3075 E COMMERCIAL BLVD STE 1A
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4318
Mailing Address - Country:US
Mailing Address - Phone:954-491-6200
Mailing Address - Fax:877-251-3308
Practice Address - Street 1:3075 E COMMERCIAL BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4318
Practice Address - Country:US
Practice Address - Phone:954-491-6200
Practice Address - Fax:877-251-3308
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40882208M00000X
FLME108170207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3337979Medicare ID - Type Unspecified
TNI50732Medicare UPIN