Provider Demographics
NPI:1477573699
Name:SINGH, JOSCELYN PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSCELYN
Middle Name:PETER
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 CLYDE MORRIS BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3196
Mailing Address - Country:US
Mailing Address - Phone:386-672-4001
Mailing Address - Fax:386-672-4006
Practice Address - Street 1:335 CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174
Practice Address - Country:US
Practice Address - Phone:386-672-4001
Practice Address - Fax:386-672-4006
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0063880207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378275100Medicaid
FL378275100Medicaid
FLF75998Medicare UPIN