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General NPI Number Information
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NPI Number | 1215314018
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Entity Type | Organization
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Legal Business Name | PRAMOD JOSEPH MD LLC
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 2215 NEBRASKA AVE STE 1A
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City | FORT PIERCE
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State | FL
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Zip | 34950-4864
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Country | US
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Telephone | 772-567-6181
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Fax | 772-567-8242
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Provider Business Mailing Address
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Address Line | 2122 MILANO CT
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-6705
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Country | US
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Telephone | 772-567-6181
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Fax | 772-567-8242
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Authorized Official
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Title or Position | PRESIDENT
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Name | PRAMOD JOSEPH
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Credential | M.D.
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Telephone | 772-567-6181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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