Provider Demographics
NPI:1861183014
Name:CAMPBELL, JULIA ROSE (OD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7902 ROCKRIMMON
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-5348
Mailing Address - Country:US
Mailing Address - Phone:210-289-0026
Mailing Address - Fax:
Practice Address - Street 1:900 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-3069
Practice Address - Country:US
Practice Address - Phone:305-326-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6249152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist