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General NPI Number Information
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NPI Number | 1265699581
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Entity Type | Organization
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Legal Business Name | JOEL L. RUSH D.O, P.A.
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 1960 NE 47 STREET SUITE 102
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-7708
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Country | US
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Telephone | 954-463-3200
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Fax | 954-463-3292
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Provider Business Mailing Address
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Address Line | 1960 NE 47 STREET SUITE 102
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-7708
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Country | US
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Telephone | 954-463-3200
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Fax | 954-463-3292
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOEL L RUSH
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Credential | D.O.
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Telephone | 954-463-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | OS5228
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | OS5228
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License Number State | FL
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