Provider Demographics
NPI:1881898377
Name:ST JULIEN, JAMII (MD)
Entity type:Individual
Prefix:
First Name:JAMII
Middle Name:
Last Name:ST JULIEN
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 1:9332 STATE ROAD 54 STE 303
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1810
Mailing Address - Country:US
Mailing Address - Phone:727-375-8313
Mailing Address - Fax:727-376-8321
Practice Address - Street 1:9332 STATE ROAD 54 STE 303
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1810
Practice Address - Country:US
Practice Address - Phone:727-375-8313
Practice Address - Fax:727-375-8321
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126530208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017734600Medicaid
FL017734600Medicaid