Provider Demographics
NPI:1033587977
Name:FUTCH, JOANNA RUTH
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:RUTH
Last Name:FUTCH
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JOANNA
Other - Middle Name:RUTH
Other - Last Name:CAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 FAIRWAY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1814
Mailing Address - Country:US
Mailing Address - Phone:888-880-9270
Mailing Address - Fax:
Practice Address - Street 1:3030 N ROCKY POINT DR W
Practice Address - Street 2:SUITE 150A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5803
Practice Address - Country:US
Practice Address - Phone:954-603-7885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist