Provider Demographics
NPI:1700044914
Name:JOSEPH, MARIE BIBLONDE (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:BIBLONDE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:M.
Other - Middle Name:BIBLONDE
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:1500 N DIXIE HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2716
Mailing Address - Country:US
Mailing Address - Phone:561-290-2610
Mailing Address - Fax:561-300-8920
Practice Address - Street 1:1500 N DIXIE HWY STE 202
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2716
Practice Address - Country:US
Practice Address - Phone:561-290-2610
Practice Address - Fax:561-300-8920
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-26
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3306213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAS397XMedicare PIN