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Individual

MR. JOSHUA MICHAEL DEARTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
151 PINE LAKE DR UNIT B, PONTE VEDRA, FL 32081-5136
(904) 543-3677
Mailing address
151 PINE LAKE DRIVE, SUITEB, POINTE VEDRA, FL 32081-2584
(904) 543-3677

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50-004097
OH
363A00000X
Physician Assistant
Primary
PA9110420
FL

Other

Enumeration date
09/23/2014
Last updated
04/23/2020
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