Provider Demographics
NPI:1083794499
Name:NORMAN, JOSH WALKER (PA)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:WALKER
Last Name:NORMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5831 BEE RIDGE RD
Mailing Address - Street 2:#100 NEUROSURGERY AND SPINE SPECIALISTS
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5088
Mailing Address - Country:US
Mailing Address - Phone:941-308-5700
Mailing Address - Fax:941-308-5757
Practice Address - Street 1:5831 BEE RIDGE ROAD
Practice Address - Street 2:#100 NEUROSURGERY AND SPINE SPECIALISTS
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:941-308-5700
Practice Address - Fax:941-308-5757
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9102424363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL291789100Medicaid
34558OtherBCBS
FL2559628OtherUNITED HEALTHCARE
34558OtherBCBS
FL291789100Medicaid