Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN 16703 | FL |
Y | 213EG0000X | General Practice | DN 16703 | FL |
NPI | 1003023722 |
---|---|
Provider Name | Dr. Julia Dison |
First Address | Hollywood, FL 33019-4878 |
Second Address | Miami Shores, FL 33138-2758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |