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NPI Code Detail

MEDICARE: JENNY F JOSEPH

MEDICARE:   JENNY F JOSEPH
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
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1770362360
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY F JOSEPH
Provider Business Mailing Address
First Line : 4404 DOLPHIN DR
Second Line :
City : TAMPA
State : FL
Zip : 33617-8304
Country : US
Telephone Number : 914-987-5922
Fax Number :
Provider Business Practice Location Address
First Line : 4404 DOLPHIN DR
Second Line :
City : TAMPA
State : FL
Zip : 33617-8304
Country : US
Telephone Number : 914-987-5922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2023
Last Update Date : 01/10/2024

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Directions to “ JENNY F JOSEPH ” Practice Location

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