Individual
JOSEPH DEVERELL BIANCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1890 LPGA BLVD, STE 250, DAYTONA BEACH, FL 32117-7130
(386) 274-0250
(386) 274-0269
Mailing address
11945 SAN JOSE BLVD, BLDG 300, JACKSONVILLE, FL 32223-1613
(386) 274-0250
(386) 274-0269
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME75089
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006181
FHCP
FL
Enumeration date
06/20/2005
Last updated
12/09/2022
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