Provider Demographics
NPI:1114116142
Name:JOSHI, DEVAL DINESH (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVAL
Middle Name:DINESH
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10075 S JOG RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3535
Mailing Address - Country:US
Mailing Address - Phone:561-767-9999
Mailing Address - Fax:855-699-3535
Practice Address - Street 1:10075 S JOG RD
Practice Address - Street 2:SUITE 203
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3535
Practice Address - Country:US
Practice Address - Phone:561-767-9999
Practice Address - Fax:855-699-3535
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA101244506207W00000X
FLME111612207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004397900Medicaid
FL004397900Medicaid