Provider Demographics
NPI:1609467778
Name:JOSEPH, EITHEL (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:EITHEL
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8765 S. DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33413
Mailing Address - Country:US
Mailing Address - Phone:305-740-6840
Mailing Address - Fax:305-740-5438
Practice Address - Street 1:8765 S. DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33413
Practice Address - Country:US
Practice Address - Phone:305-740-6840
Practice Address - Fax:305-740-5438
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31977183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist