Provider Demographics
NPI:1144402538
Name:DESAMOUR, JOSENIE (INTERNAL MEDICINE)
Entity Type:Individual
Prefix:DR
First Name:JOSENIE
Middle Name:
Last Name:DESAMOUR
Suffix:
Gender:F
Credentials:INTERNAL MEDICINE
Other - Prefix:DR
Other - First Name:JOSENIE
Other - Middle Name:
Other - Last Name:DESAMOUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:441 NW 188TH TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-3297
Mailing Address - Country:US
Mailing Address - Phone:305-319-1521
Mailing Address - Fax:
Practice Address - Street 1:2525 HIGHWAY 44 W
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3722
Practice Address - Country:US
Practice Address - Phone:301-556-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine