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General NPI Number Information
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NPI Number | 1174720734
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Entity Type | Individual
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Provider Name | JOSEPH MY D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 501 SE OSCEOLA ST STE 301
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City | STUART
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State | FL
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Zip | 34994
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Country | US
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Telephone | 772-223-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 501 SE OSCEOLA ST STE 301
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City | STUART
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State | FL
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Zip | 34994-2347
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Country | US
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Telephone | 772-223-5955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0102202359
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | OS14909
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License Number State | FL
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