Provider Demographics
NPI:1962499319
Name:BIASE, JOSEPH N (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:N
Last Name:BIASE
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 1:10151 ENTERPRISE CENTER BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3759
Mailing Address - Country:US
Mailing Address - Phone:561-737-9191
Mailing Address - Fax:561-733-9145
Practice Address - Street 1:10151 ENTERPRISE CENTER BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3759
Practice Address - Country:US
Practice Address - Phone:561-737-9191
Practice Address - Fax:561-733-9145
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0065660208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF80165Medicare UPIN
FL25128ZMedicare ID - Type Unspecified