MEDICARE: MS. NISHA JOSEY RD

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
1	133V00000X	Registered Dietitian	10132	FL

General Provider Information

NPI Number	:	1588455711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NISHA JOSEY RD

Provider Business Mailing Address
First Line	:	2839 TAYLOR ST APT 4
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4248
Country	:	US
Telephone Number	:	561-592-0283
Fax Number	:

Provider Business Practice Location Address
First Line	:	2839 TAYLOR ST APT 4
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4248
Country	:	US
Telephone Number	:	561-592-0283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	05/15/2025

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