Healthcare Provider Details

I. General information

NPI: 1184833154
Provider Name (Legal Business Name): JOSEPH MICHAEL FICARRA HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2298 NW BOCA RATON BLVD SUITE 14
BOCA RATON FL
33431-7458
US

IV. Provider business mailing address

2298 NW BOCA RATON BLVD SUITE 14
BOCA RATON FL
33431-7458
US

V. Phone/Fax

Practice location:
  • Phone: 888-443-2725
  • Fax: 561-338-2981
Mailing address:
  • Phone: 888-443-2725
  • Fax: 561-338-2981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS1952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: