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NPI Code Detail

MEDICARE: DR. JESSICA SAJI JOSEPH MD

MEDICARE: DR. JESSICA SAJI JOSEPH MD
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
1208000000XPediatrics PhysicianME178742FL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1528756756
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA SAJI JOSEPH MD
Provider Business Mailing Address
First Line : 4500 PARSONS BLVD STE 410
Second Line :
City : FLUSHING
State : NY
Zip : 11355-2205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2140 E EDGEWOOD DR
Second Line :
City : LAKELAND
State : FL
Zip : 33803-3604
Country : US
Telephone Number : 863-669-1212
Fax Number : 863-666-6089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2023
Last Update Date : 06/03/2026

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Directions to “ DR. JESSICA SAJI JOSEPH MD” Practice Location

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