Provider Demographics
NPI:1609832203
Name:ADAN, JOSEPH I (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:I
Last Name:ADAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:I
Other - Last Name:ADAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1938 SOULE RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1507
Mailing Address - Country:US
Mailing Address - Phone:727-726-7442
Mailing Address - Fax:727-288-1111
Practice Address - Street 1:1938 SOULE RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1507
Practice Address - Country:US
Practice Address - Phone:727-726-7442
Practice Address - Fax:727-288-1111
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME664032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G53949Medicare UPIN
FL31835ZMedicare ID - Type Unspecified