Provider Demographics
NPI:1134145618
Name:ETIENNE, JOSEPH HERVE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HERVE
Last Name:ETIENNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20423 STATE ROAD 7 STE F6 #287
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6792
Mailing Address - Country:US
Mailing Address - Phone:561-995-6971
Mailing Address - Fax:
Practice Address - Street 1:5401 S CONGRESS AVE STE 201
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6637
Practice Address - Country:US
Practice Address - Phone:561-995-6971
Practice Address - Fax:561-569-8309
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 94948207Q00000X
FLME0094948207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine