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NPI Code Detail

MEDICARE: JOSEPHINE JOHN

MEDICARE: JOSEPHINE JOHN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner11038350FL

General Provider Information

NPI Number : 1063375012
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPHINE JOHN
Provider Business Mailing Address
First Line : 1016 BENT CREEK DR
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-1333
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 701 N FEDERAL HWY STE 501
Second Line :
City : HALLANDALE BEACH
State : FL
Zip : 33009-2467
Country : US
Telephone Number : 954-723-6868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2025
Last Update Date : 03/17/2026

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Directions to “ JOSEPHINE JOHN ” Practice Location

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