Healthcare Provider Details

I. General information

NPI: 1568876191
Provider Name (Legal Business Name): JOSEPH JUDE EVENS VINCENT FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 COCONUT CREEK PKWY
MARGATE FL
33063-3913
US

IV. Provider business mailing address

5100 COCONUT CREEK PKWY
MARGATE FL
33063-3913
US

V. Phone/Fax

Practice location:
  • Phone: 954-281-7700
  • Fax: 954-715-7603
Mailing address:
  • Phone: 954-281-7700
  • Fax: 954-715-7603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF338725-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9340100
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: