Provider Demographics
NPI:1841235926
Name:ANCHETA, JOEY S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEY
Middle Name:S
Last Name:ANCHETA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6826 W LINEBAUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4951
Mailing Address - Country:US
Mailing Address - Phone:813-388-2935
Mailing Address - Fax:813-280-6193
Practice Address - Street 1:6826 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4951
Practice Address - Country:US
Practice Address - Phone:813-388-2935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72598207QA0505X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258285600Medicaid
FL49745OtherBCBSF
FL49745YMedicare PIN
H11673Medicare UPIN
FL49745OMedicare PIN