Provider Demographics
NPI:1750501359
Name:JOSEPH, DAREN (D,C)
Entity Type:Individual
Prefix:
First Name:DAREN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:D,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4477
Mailing Address - Country:US
Mailing Address - Phone:954-455-2030
Mailing Address - Fax:954-455-2040
Practice Address - Street 1:800 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 14
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4477
Practice Address - Country:US
Practice Address - Phone:954-455-2030
Practice Address - Fax:954-455-2040
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2646ZMedicare PIN