Provider Demographics
NPI:1457054314
Name:JOSEPH, JOSH CHERUKARA (DPM)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:CHERUKARA
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:PHILIP
Other - Middle Name:CHERUKARA
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5301 SOUTH CONGRESS AVENUE
Mailing Address - Street 2:3 SOUTH
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462
Mailing Address - Country:US
Mailing Address - Phone:561-548-1710
Mailing Address - Fax:561-548-1743
Practice Address - Street 1:5301 SOUTH CONGRESS AVENUE
Practice Address - Street 2:4 SOUTH
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:561-548-1710
Practice Address - Fax:561-548-1743
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program