Healthcare Provider Details

I. General information

NPI: 1609732718
Provider Name (Legal Business Name): JOSHUA AARON SEGAL MSN, APRN, AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10543 PONTOFINO CIR
TRINITY FL
34655-7060
US

IV. Provider business mailing address

10543 PONTOFINO CIR
TRINITY FL
34655-7060
US

V. Phone/Fax

Practice location:
  • Phone: 727-251-6193
  • Fax:
Mailing address:
  • Phone: 727-251-6193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11041732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: