Provider Demographics
NPI:1043932577
Name:CHAMORRO, JOSHUA ALEXANDER
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALEXANDER
Last Name:CHAMORRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NW 141ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-6840
Mailing Address - Country:US
Mailing Address - Phone:786-859-2028
Mailing Address - Fax:
Practice Address - Street 1:1000 NW 141ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-6840
Practice Address - Country:US
Practice Address - Phone:786-859-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician