Provider Demographics
NPI:1255310579
Name:JOYCE, DOUGLAS H
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:H
Last Name:JOYCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS71042086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57222Medicare PIN
FLE53622Medicare UPIN
FL57222YMedicare PIN