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Individual

MR. MICHAEL JOSAPHAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2311 10TH AVE N, SUITE 11, LAKE WORTH, FL 33461-6605
(954) 234-9203
(561) 469-6719
Mailing address
2311 10TH AVE N, SUITE 11, LAKE WORTH, FL 33461-6605
(954) 234-9203
(561) 469-6719

Taxonomy

Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
CRT57773
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HCC10329
AHCA
FL
Enumeration date
09/23/2016
Last updated
09/23/2016
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