Healthcare Provider Details

I. General information

NPI: 1740965763
Provider Name (Legal Business Name): JOSHUA DEAN MEADE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 06/19/2023
Certification Date: 06/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 E ROLLINS ST STE 11100
ORLANDO FL
32804-5519
US

IV. Provider business mailing address

265 E ROLLINS ST STE 11100
ORLANDO FL
32804-5519
US

V. Phone/Fax

Practice location:
  • Phone: 407-084-4407
  • Fax:
Mailing address:
  • Phone: 844-407-4070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number38316
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: