Individual
PROSPER JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1774 15TH AVE N, LAKE WORTH, FL 33460-1734
(407) 965-9329
(786) 272-0476
Mailing address
1774 15TH AVE N, LAKE WORTH, FL 33460-1734
(407) 965-9329
(786) 272-0476
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
2343212
FL
183700000X
Pharmacy Technician
RPHT3903
FL
Other
Enumeration date
07/21/2014
Last updated
01/19/2017
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