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NPI Code Detail

MEDICARE: JOSEPH PRAVER

MEDICARE: JOSEPH PRAVER
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
1367H00000XAnesthesiologist Assistant

Other Identifiers

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

General Provider Information

NPI Number : 1659880631
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH PRAVER
Provider Business Mailing Address
First Line : 1401 RIVERPLACE BLVD
Second Line : 1907
City : JACKSONVILLE
State : FL
Zip : 32207-9069
Country : US
Telephone Number : 321-684-9967
Fax Number :
Provider Business Practice Location Address
First Line : 800 PRUDENTIAL DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8202
Country : US
Telephone Number : 904-202-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2017
Last Update Date : 09/22/2017

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Directions to “ JOSEPH PRAVER ” Practice Location

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