Individual provider Active NPI

Julianna Maloree Sanjuan, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1487249793
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW19417 Issued in FL
Practice address
2400 E Commercial Blvd Ste 101
Fort Lauderdale, FL 33308-4022
Phone
(754) 243-5650
Fax
(954) 756-9582
NPI assigned
Mar 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW19417 FL Primary

Addresses

Primary practice location

2400 E Commercial Blvd Ste 101
Fort Lauderdale, FL 33308-4022

Mailing address

2400 E Commercial Blvd Ste 101
Fort Lauderdale, FL 33308-4022
Phone (754) 243-5650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425002314 FL Practitioner - Clinical Social Worker 8527455385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

2400 E Commercial Blvd
Suite 101
Fort Lauderdale, FL 33308-4022
Phone (754) 243-5650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW19417FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Apr 5, 2022 Accepting new patients

Locations

8570 Granite Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 310-4646

2400 E Commercial Blvd
Ste 101
Ft Lauderdale, FL 33308
Phone (754) 243-5650

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1487249793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 E COMMERCIAL BLVD STE 101",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084022",
            "telephone_number": "754-243-5650",
            "fax_number": "954-756-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E COMMERCIAL BLVD STE 101",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084022",
            "telephone_number": "754-243-5650",
            "fax_number": "954-756-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANJUAN",
        "first_name": "JULIANNA",
        "middle_name": "MALOREE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.