Provider Demographics
NPI:1548088743
Name:NIEDERMEYER, JULES ADRIEN (PA-C)
Entity type:Individual
Prefix:
First Name:JULES
Middle Name:ADRIEN
Last Name:NIEDERMEYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1084 BRIELLE CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5402
Mailing Address - Country:US
Mailing Address - Phone:203-802-7022
Mailing Address - Fax:
Practice Address - Street 1:1360 SAXON BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8416
Practice Address - Country:US
Practice Address - Phone:386-917-0074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant