Individual
DR. JOSEPH E TIENSTRA
Active
Individual
DR. JOSEPH E TIENSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME0045066
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004093006
AETNA
—
01
—
205472
AMERIGROUP
—
01
—
300064841
RR MEDICARE
FL
01
—
36420
BCBSFL
—
01
—
ME45066
FL WC CERTIFICATION
—
05
—
O36234400
—
FL
Enumeration date
05/27/2006
Last updated
04/09/2014
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