MEDICARE: JOSEPH SURGERY LLC

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	174400000X	Specialist	ME111651	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	:	1649540725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH SURGERY LLC

Provider Business Mailing Address
First Line	:	9415 NE 6TH AVE
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2737
Country	:	US
Telephone Number	:	786-401-6455
Fax Number	:	786-401-6394

Provider Business Practice Location Address
First Line	:	9415 NE 6TH AVE
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2737
Country	:	US
Telephone Number	:	786-401-6455
Fax Number	:	786-401-6394

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROMANE JOSEPH
Credential	:	M.D.
Telephone Number	:	786-401-6455

Provider Enumeration Date	:	01/06/2012
Last Update Date	:	04/09/2013

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Directions to “JOSEPH SURGERY LLC ” Practice Location

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