Provider Demographics
NPI:1164849303
Name:HAN, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD RM N-203
Mailing Address - Street 2:P.O. BOX 100247
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0247
Mailing Address - Country:US
Mailing Address - Phone:352-273-8634
Mailing Address - Fax:352-273-0247
Practice Address - Street 1:1600 SW ARCHER RD RM N-203
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0247
Practice Address - Country:US
Practice Address - Phone:352-273-8634
Practice Address - Fax:352-273-0247
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME138863208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program