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General NPI Number Information
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NPI Number | 1326861121
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Entity Type | Individual
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Provider Name | JOSEPH SIVOLI CRPS
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Gender | Male
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 709 EDGEWATER DR
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City | ORLANDO
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State | FL
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Zip | 32804-6815
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Country | US
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Telephone | 407-676-4068
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 BAXTER AVE
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City | ORLANDO
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State | FL
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Zip | 32806-6412
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Country | US
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Telephone | 414-241-9480
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | CRPS.0101636.A
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License Number State | FL
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