Provider Demographics
NPI:1255600052
Name:DAVID V. JOSEPH
Entity type:Organization
Organization Name:DAVID V. JOSEPH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:V
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-753-0505
Mailing Address - Street 1:793 HEALTH CARE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8334
Mailing Address - Country:US
Mailing Address - Phone:386-753-0505
Mailing Address - Fax:386-753-0338
Practice Address - Street 1:793 HEALTH CARE DR
Practice Address - Street 2:STE103
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8334
Practice Address - Country:US
Practice Address - Phone:386-753-0505
Practice Address - Fax:386-753-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207RI0011X207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41506Medicare UPIN