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Organization

PIVOTAL HEALTH PHYSICAL MEDICINE, LLC

Active
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Organization

PIVOTAL HEALTH PHYSICAL MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEREMIAH B JOSEPH DC (PRESIDENT)
(941) 473-7900
Entity
Organization

Contact information

Practice address
12479 S ACCESS RD, SUITE 1, PORT CHARLOTTE, FL 33981-6206
(941) 697-3001
(941) 697-6010
Mailing address
12479 S ACCESS RD, SUITE 1, PORT CHARLOTTE, FL 33981-6206
(941) 697-3001
(941) 697-6010

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH8839
FL
207R00000X
Internal Medicine Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—

Other

Enumeration date
02/17/2012
Last updated
07/09/2014
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