Provider Demographics
NPI:1265858468
Name:FILS-AIME, JOSUE
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:
Last Name:FILS-AIME
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 1:8019 CHERRY BRANCH DR.
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33573
Mailing Address - Country:US
Mailing Address - Phone:941-580-4657
Mailing Address - Fax:
Practice Address - Street 1:8019 CHERRY BRANCH DR.
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33573
Practice Address - Country:US
Practice Address - Phone:941-580-4657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL52963047311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home