Provider Demographics
NPI:1538930177
Name:HANZE, JULIO
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:HANZE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JULIO
Other - Middle Name:
Other - Last Name:HANZE JIMENEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:380 HOSPITAL DRIVE
Mailing Address - Street 2:BUILDING A, SUITE 430
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-8017
Mailing Address - Country:US
Mailing Address - Phone:478-751-0367
Mailing Address - Fax:
Practice Address - Street 1:170 MANNING DRIVE ST 1116
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-3838
Practice Address - Country:US
Practice Address - Phone:919-350-7828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NCRTL25-0394390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program