Basic Information
Provider Information
NPI: 1417138447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUARTE
FirstName: JULIO
MiddleName: D
NamePrefix: DR.
NameSuffix: JR.
Credential: PHARM.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 SW ARCHER RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1601 SW ARCHER RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber: 3525486000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/19/2007
LastUpdateDate: 11/29/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XPS41413FLN Pharmacy Service ProvidersPharmacist 
183500000XPS54708FLY Pharmacy Service ProvidersPharmacist 

No ID Information.


Home