Provider Demographics
NPI:1578705331
Name:JOSEPH, RATHI LAKSHMI (DO)
Entity Type:Individual
Prefix:DR
First Name:RATHI
Middle Name:LAKSHMI
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:RATHI
Other - Middle Name:LAKSHMI
Other - Last Name:RAVIKUMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
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:386-274-2977
Mailing Address - Fax:386-274-2997
Practice Address - Street 1:21 HOSPITAL DR
Practice Address - Street 2:SUITE 120
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2452
Practice Address - Country:US
Practice Address - Phone:358-586-2280
Practice Address - Fax:386-274-3682
Is Sole Proprietor?:No
Enumeration Date:2009-03-25
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1328572081S0010X
FLOS12786208VP0014X, 2081P2900X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program