Provider Demographics
NPI:1801145958
Name:POLLOCK, JULIANA
Entity type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:
Last Name:POLLOCK
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:COND JARD DE SAN FRANCISCO
Mailing Address - Street 2:APT 1003-I
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6440
Mailing Address - Country:US
Mailing Address - Phone:787-908-7472
Mailing Address - Fax:
Practice Address - Street 1:101 AVE SAN PATRICIO
Practice Address - Street 2:SUITE 1150
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-2645
Practice Address - Country:US
Practice Address - Phone:787-793-2623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist