Organization
JOSEPH J DAVERSA JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH JAMES DAVERSA JR. MD (PRESIDENT)
(305) 253-4218
Entity
Organization
Contact information
Practice address
12368 SW 82ND AVE, MIAMI, FL 33156-5223
(305) 253-4218
(305) 233-5844
Mailing address
12368 SW 82ND AVE, MIAMI, FL 33156-5223
(305) 253-4218
(305) 233-5844
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME 0014994
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049162400
—
FL
Enumeration date
02/23/2006
Last updated
03/30/2011
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