Provider Demographics
NPI:1336401538
Name:JOSEPH, MAGDALEINA V (PHD, AAPRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:MAGDALEINA
Middle Name:V
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PHD, AAPRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18503 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1404
Mailing Address - Country:US
Mailing Address - Phone:954-902-6442
Mailing Address - Fax:954-902-6357
Practice Address - Street 1:18503 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1404
Practice Address - Country:US
Practice Address - Phone:954-902-6442
Practice Address - Fax:954-902-6357
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9187742363LP0808X, 363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$Medicaid