Organization
MARY JOSEFYK DNP APRN PA
Active
Other names
Main Avenue Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E JOSEFYK DNP APRN (PRESIDENT)
(863) 840-6095
Entity
Organization
Contact information
Practice address
13 N MAIN AVE, LAKE PLACID, FL 33852-2603
(863) 659-1079
(863) 659-1317
Mailing address
PO BOX 718, LAKE PLACID, FL 33862-0718
(863) 659-1079
(863) 659-1317
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/25/2023
Last updated
10/20/2023
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