Provider Demographics
NPI:1295537405
Name:JOSEPH, FABROLA (RN)
Entity type:Individual
Prefix:MRS
First Name:FABROLA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:
Credentials:RN
Other - Prefix:MISS
Other - First Name:FABROLA
Other - Middle Name:
Other - Last Name:BAPTISTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:274 MEADOWBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-9751
Mailing Address - Country:US
Mailing Address - Phone:561-515-9185
Mailing Address - Fax:
Practice Address - Street 1:470 CITI CTR ST # 1013
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3425
Practice Address - Country:US
Practice Address - Phone:561-515-9185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9646808163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse