Provider Demographics
NPI:1538875232
Name:KING, JULIA T (DOM, AP)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:T
Last Name:KING
Suffix:
Gender:F
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 50TH ST W APT 1409
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2874
Mailing Address - Country:US
Mailing Address - Phone:941-500-2594
Mailing Address - Fax:
Practice Address - Street 1:1810 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3112
Practice Address - Country:US
Practice Address - Phone:941-822-0957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4394171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty