Healthcare Provider Details

I. General information

NPI: 1245663541
Provider Name (Legal Business Name): LOVELIE JOSEPH RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2013
Last Update Date: 04/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 SW 85TH AVE
MIRAMAR FL
33025-2955
US

IV. Provider business mailing address

10561 MARIN RANCHES DR
COOPER CITY FL
33328-6301
US

V. Phone/Fax

Practice location:
  • Phone: 786-539-7650
  • Fax:
Mailing address:
  • Phone: 786-539-7650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number12517
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: