Provider Demographics
NPI:1255974119
Name:JOJI, LOVELY
Entity type:Individual
Prefix:
First Name:LOVELY
Middle Name:
Last Name:JOJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 CAPE COD TER
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3022
Mailing Address - Country:US
Mailing Address - Phone:561-309-9689
Mailing Address - Fax:
Practice Address - Street 1:2100 45TH ST STE A 8/9
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2016
Practice Address - Country:US
Practice Address - Phone:561-840-8681
Practice Address - Fax:561-844-0764
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty