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General NPI Number Information
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NPI Number | 1154614907
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Entity Type | Organization
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Legal Business Name | JOSH TRUTT, MD, PLLC
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 1425 SW 8TH CT
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City | FT LAUDERDALE
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State | FL
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Zip | 33312
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Country | US
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Telephone | 786-723-3435
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Fax |
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Provider Business Mailing Address
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Address Line | 1126 S. FEDERAL HIGHWAYSUITE 610
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City | FT. LAUDERDALE
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State | FL
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Zip | 33316
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSH TRUTT
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Credential | M.D.
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Telephone | 786-723-3435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 207618
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License Number State | NY
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