Provider Demographics
NPI:1851440333
Name:PESEK, JOSEPH III (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:PESEK
Suffix:III
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 1:4600 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-4764
Mailing Address - Country:US
Mailing Address - Phone:904-346-5100
Mailing Address - Fax:904-346-5111
Practice Address - Street 1:4600 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4764
Practice Address - Country:US
Practice Address - Phone:904-346-5100
Practice Address - Fax:904-346-5111
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME244952080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics