Healthcare Provider Details

I. General information

NPI: 1790760643
Provider Name (Legal Business Name): NIRMAL JAY JOSEPH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9370 SUNSET DR SUITE A-250
MIAMI FL
33173-5431
US

IV. Provider business mailing address

PO BOX 840207
PEMBROKE PINES FL
33084-2207
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-4510
  • Fax:
Mailing address:
  • Phone: 305-595-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME91539
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberPT22173
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: