MEDICARE: MRS. ELIANE BRENDA JOSEPH RN

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	163WH0200X	Home Health Registered Nurse	RN9326551	FL

General Provider Information

NPI Number	:	1225462252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIANE BRENDA JOSEPH RN

Provider Business Mailing Address
First Line	:	1100 NE 125TH ST STE 210
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-5046
Country	:	US
Telephone Number	:	305-989-0261
Fax Number	:	305-907-5260

Provider Business Practice Location Address
First Line	:	1100 NE 125TH ST STE 210
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-5046
Country	:	US
Telephone Number	:	305-989-0261
Fax Number	:	305-907-5260

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

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	08/27/2013

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