Provider Demographics
NPI:1164606752
Name:DOUGLAS H JOYCE DO PA
Entity Type:Organization
Organization Name:DOUGLAS H JOYCE DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-575-0123
Mailing Address - Street 1:25092 OLYMPIA AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-3933
Mailing Address - Country:US
Mailing Address - Phone:941-575-0123
Mailing Address - Fax:941-575-4191
Practice Address - Street 1:25092 OLYMPIA AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3933
Practice Address - Country:US
Practice Address - Phone:941-575-0123
Practice Address - Fax:941-575-4191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57222OtherBCBS
FLAI700Medicare PIN