Healthcare Provider Details

I. General information

NPI: 1154952737
Provider Name (Legal Business Name): JOSHUA HESTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 BRUNSON DR
CORAL GABLES FL
33146-2412
US

IV. Provider business mailing address

PO BOX 141992
CORAL GABLES FL
33114-1992
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-3666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number128735
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: