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Individual

MR. GRAVIL JOSEPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
10515 SW 24TH ST, MIRAMAR, FL 33025-3996
(305) 767-0887
Mailing address
10515 SW 24TH ST, MIRAMAR, FL 33025-3996
(305) 767-0887

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
AP60792299
WA
207QA0505X
Adult Medicine Physician
AP11258
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9359865
FL
363LP2300X
Primary Care Nurse Practitioner
9359865
FL

Other

Enumeration date
02/03/2017
Last updated
06/07/2022
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