Healthcare Provider Details

I. General information

NPI: 1457815599
Provider Name (Legal Business Name): JOSHUA CALEB PRICE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 GULF BREEZE PKWY
GULF BREEZE FL
32561-7809
US

IV. Provider business mailing address

PO BOX 95590
SOUTH JORDAN UT
84095-0590
US

V. Phone/Fax

Practice location:
  • Phone: 850-916-8700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9111983
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: