Healthcare Provider Details

I. General information

NPI: 1457846966
Provider Name (Legal Business Name): KATHERINE MARIE JOSEPH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 15245
APO AP
96271-5245
US

IV. Provider business mailing address

7321 SW 9TH ST
PLANTATION FL
33317-4101
US

V. Phone/Fax

Practice location:
  • Phone: 954-655-9567
  • Fax:
Mailing address:
  • Phone: 954-655-9567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number72721-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: