Healthcare Provider Details

I. General information

NPI: 1396065926
Provider Name (Legal Business Name): JOHN P JOSEPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2010
Last Update Date: 06/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 NE 167TH ST
NORTH MIAMI BEACH FL
33162-2305
US

IV. Provider business mailing address

357 NE 167TH ST
NORTH MIAMI BEACH FL
33162-2305
US

V. Phone/Fax

Practice location:
  • Phone: 786-487-5630
  • Fax:
Mailing address:
  • Phone: 786-487-5630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT9465
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: