Provider Demographics
NPI:1700232667
Name:JOSEPH, CANDICE THEODORA (MD)
Entity Type:Individual
Prefix:MISS
First Name:CANDICE
Middle Name:THEODORA
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:356 E MIDWAY RD
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-7148
Mailing Address - Country:US
Mailing Address - Phone:772-464-9746
Mailing Address - Fax:772-464-9750
Practice Address - Street 1:356 E MIDWAY RD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-7148
Practice Address - Country:US
Practice Address - Phone:772-464-9746
Practice Address - Fax:772-474-9750
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLM150117207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease