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Organization
JOSEPH THEVENIN JR, MD PA
Active
Organization
JOSEPH THEVENIN JR, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH THEVENIN JR, MD JR. MD (MEDICAL DOCTOR)
(305) 238-8561
Entity
Organization
Contact information
Practice address
9635 SW 181 TERRACE, PALMETTO BAY, PALMETTO BAY, FL 33157-5630
(305) 238-8561
(305) 238-4089
Mailing address
9635 SW 181 TERRACE, PALMETTO BAY, FL 33157-5630
(305) 238-8561
(305) 238-4089
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0061428
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059735001
—
FL
Enumeration date
12/03/2010
Last updated
12/03/2010
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