Healthcare Provider Details

I. General information

NPI: 1376801589
Provider Name (Legal Business Name): DENISE JOSEY MD, MPH, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 05/13/2022
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 LANTANA RD
LAKE WORTH FL
33463-6915
US

IV. Provider business mailing address

5917-5919 WEBB ROAD
TAMPA FL
33615-3286
US

V. Phone/Fax

Practice location:
  • Phone: 561-790-8072
  • Fax:
Mailing address:
  • Phone: 813-682-0092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberME131175
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberME131175
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME131175
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: