Provider Demographics
NPI:1396999223
Name:RIDER, JOSEPH FRANK
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:FRANK
Last Name:RIDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 18TH ST
Mailing Address - Street 2:APT E 4
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5647
Mailing Address - Country:US
Mailing Address - Phone:772-532-1169
Mailing Address - Fax:
Practice Address - Street 1:400 18TH ST
Practice Address - Street 2:APT E 4
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32967-5647
Practice Address - Country:US
Practice Address - Phone:772-532-1169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health