Healthcare Provider Details

I. General information

NPI: 1801707807
Provider Name (Legal Business Name): JOSHUA THOMPSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5828 NW 23RD ST
LAUDERHILL FL
33313-3184
US

IV. Provider business mailing address

5828 NW 23RD ST
LAUDERHILL FL
33313-3184
US

V. Phone/Fax

Practice location:
  • Phone: 954-931-0259
  • Fax:
Mailing address:
  • Phone: 954-931-0259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: