Provider Demographics
NPI:1083470058
Name:JOSEPH, ARUN ANTONY (RN)
Entity Type:Individual
Prefix:
First Name:ARUN
Middle Name:ANTONY
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 WINYAH DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1226
Mailing Address - Country:US
Mailing Address - Phone:407-303-7747
Mailing Address - Fax:
Practice Address - Street 1:453 S COLLINS ST
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-2454
Practice Address - Country:US
Practice Address - Phone:224-578-8337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered