Provider Demographics
NPI:1902250905
Name:IGLESIAS, JULIO M (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:M
Last Name:IGLESIAS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1834 W 72ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3709
Mailing Address - Country:US
Mailing Address - Phone:786-326-4785
Mailing Address - Fax:
Practice Address - Street 1:1834 W 72ND PL
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-3709
Practice Address - Country:US
Practice Address - Phone:786-326-4785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-16
Last Update Date:2016-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9320274163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse