Provider Demographics
NPI:1497703342
Name:JOY, DAMIEN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:DAMIEN
Middle Name:CHRISTOPHER
Last Name:JOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10115 W FOREST HILL BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3105
Mailing Address - Country:US
Mailing Address - Phone:561-204-4400
Mailing Address - Fax:561-204-4455
Practice Address - Street 1:10115 W FOREST HILL BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3105
Practice Address - Country:US
Practice Address - Phone:561-204-4400
Practice Address - Fax:561-204-4455
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058003208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE57268Medicare UPIN
FL10611AMedicare ID - Type Unspecified