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NPI Code Detail

MEDICARE: CHRISTINE MARIE JOSEPH PA-C

MEDICARE: CHRISTINE MARIE JOSEPH PA-C
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
1363A00000XPhysician Assistant
2390200000XStudent in an Organized Health Care Education/Training Program
3363A00000XPhysician Assistant9117941FL

General Provider Information

NPI Number : 1194409664
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE MARIE JOSEPH PA-C
Provider Business Mailing Address
First Line : 700 QUEENS HARBOR BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-4901
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3122 NEW BERLIN RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32226-1828
Country : US
Telephone Number : 904-633-0340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2023
Last Update Date : 01/28/2024

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Directions to “ CHRISTINE MARIE JOSEPH PA-C” Practice Location

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