Provider Demographics
NPI:1861935264
Name:JULES, ILMINE
Entity type:Individual
Prefix:
First Name:ILMINE
Middle Name:
Last Name:JULES
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 1:22660 SW 65TH TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-6023
Mailing Address - Country:US
Mailing Address - Phone:954-993-0450
Mailing Address - Fax:
Practice Address - Street 1:22660 SW 65TH TER
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-6023
Practice Address - Country:US
Practice Address - Phone:954-993-0450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services