Individual
NANCY JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.B.,B.S.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(732) 439-1486
Mailing address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(732) 439-1486
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME131239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021268600
—
FL
01
—
IZ657Z
MEDICARE PTAN
FL
Enumeration date
07/17/2014
Last updated
07/17/2017
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