Provider Demographics
NPI:1316189905
Name:JOSEPH, ARUN GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:GEORGE
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1671 N CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5590
Mailing Address - Country:US
Mailing Address - Phone:309-363-9811
Mailing Address - Fax:
Practice Address - Street 1:1165 DUNLAWTON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-2924
Practice Address - Country:US
Practice Address - Phone:386-760-0815
Practice Address - Fax:386-274-4354
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2016-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL118614208VP0000X
FLME118614208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010870900Medicaid