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Individual

JEROME N JOSEPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CERTIFIED

Contact information

Practice address
3108 6TH ST W, LEHIGH ACRES, FL 33971-1460
(239) 491-4700
(877) 836-4662
Mailing address
3108 6TH ST W, LEHIGH ACRES, FL 33971-1460
(239) 491-4700
(877) 836-4662

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
FL
347C00000X
Private Vehicle

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
XXX
ACE
FL
Enumeration date
08/05/2019
Last updated
11/27/2023
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