Provider Demographics
NPI:1871918680
Name:BRIDGER, JULIE
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:BRIDGER
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 1:1314 10TH ST
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3966
Mailing Address - Country:US
Mailing Address - Phone:305-393-0811
Mailing Address - Fax:
Practice Address - Street 1:1314 10TH ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3966
Practice Address - Country:US
Practice Address - Phone:305-393-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist