Healthcare Provider Details

I. General information

NPI: 1306997192
Provider Name (Legal Business Name): JOSEPH DESANTIS ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 NW 10TH AVE 2ND FLOOR
MIAMI FL
33136-1013
US

IV. Provider business mailing address

1580 NW 10TH AVE 2ND FLOOR
MIAMI FL
33136-1013
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-4546
  • Fax: 305-243-5562
Mailing address:
  • Phone: 305-243-4546
  • Fax: 305-243-5562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP2865622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: