MEDICARE: MR. JOSEPH ANDREW MILISITZ PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW 2245	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104827864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH ANDREW MILISITZ PH.D.

Provider Business Mailing Address
First Line	:	1355 W PALMETTO PARK RD
Second Line	:	# 310
City	:	BOCA RATON
State	:	FL
Zip	:	33486-3330
Country	:	US
Telephone Number	:	561-620-9797
Fax Number	:	561-620-7848

Provider Business Practice Location Address
First Line	:	1499 W PALMETTO PARK RD
Second Line	:	# 172
City	:	BOCA RATON
State	:	FL
Zip	:	33486-3328
Country	:	US
Telephone Number	:	561-620-9797
Fax Number	:	561-620-7848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	09/22/2009

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