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General NPI Number Information
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NPI Number | 1730111287
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Entity Type | Individual
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Provider Name | JOSHUA MARC RYCUS D.O.,P.A.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 9750 NW 33RD ST SUITE # 114
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4042
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Country | US
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Telephone | 954-753-1477
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Fax | 954-753-3626
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Provider Business Mailing Address
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Address Line | 9750 NW 33RD ST SUITE # 114
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4042
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Country | US
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Telephone | 954-753-1477
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Fax | 954-753-3626
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | OS 8863
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License Number State | FL
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