Provider Demographics
NPI:1932876141
Name:BERKAU, JULIA HUNT (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:HUNT
Last Name:BERKAU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S 11TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4239
Mailing Address - Country:US
Mailing Address - Phone:863-676-0174
Mailing Address - Fax:
Practice Address - Street 1:425 S 11TH ST STE 3
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4239
Practice Address - Country:US
Practice Address - Phone:863-676-0174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist