Basic Information
Provider Information
NPI: 1881020279
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CALMES
FirstName: JULIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 25487
Address2:  
City: SARASOTA
State: FL
PostalCode: 342772487
CountryCode: US
TelephoneNumber: 9413156182
FaxNumber:  
Practice Location
Address1: 11505 PALMBRUSH TRL STE 220
Address2:  
City: LAKEWOOD RANCH
State: FL
PostalCode: 342022915
CountryCode: US
TelephoneNumber: 9413156182
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/18/2013
LastUpdateDate: 09/18/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133N00000XND5432FLY Dietary & Nutritional Service ProvidersNutritionist 
133V00000X  N Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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