Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | APRN11011775 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN11011775 | FL |
NPI | 1346834488 |
---|---|
Provider Name | Ms. Julia A Mcdonald |
First Address | Lake Mary, FL 32746-5716 |
Second Address | Lake Mary, FL 32746-5716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2021 |
Last Update Date | 08/07/2021 |