Provider Demographics
NPI:1831718238
Name:JULIANO, ROBERT JOHN JR (LMT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:JULIANO
Suffix:JR
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 JORDAN STUART CIR APT 114
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-2408
Mailing Address - Country:US
Mailing Address - Phone:321-262-9323
Mailing Address - Fax:
Practice Address - Street 1:9401 W COLONIAL DR STE 410
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-6810
Practice Address - Country:US
Practice Address - Phone:321-262-9323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA80424225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty