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General NPI Number Information
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NPI Number | 1780024166
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Entity Type | Individual
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Provider Name | MARC PEGGY JOSEPH APRN
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Gender | Male
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 11/16/2025
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Provider Practice Location Address
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Address Line | 1814 NW 19TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-3535
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Country | US
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Telephone | 786-426-2197
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Fax |
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Provider Business Mailing Address
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Address Line | 6428 FLETCHER ST
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City | HOLLYWOOD
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State | FL
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Zip | 33023-2130
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Country | US
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Telephone | 786-426-2197
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN9291362
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | APRN9291362
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9291362
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | RN9291362
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License Number State | FL
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