Provider Demographics
NPI:1700062494
Name:IGNACIO, JOSEPH A (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:IGNACIO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:806 S DOUGLAS RD
Mailing Address - Street 2:SUITE 820
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3157
Mailing Address - Country:US
Mailing Address - Phone:305-447-4150
Mailing Address - Fax:305-448-8186
Practice Address - Street 1:806 S DOUGLAS RD
Practice Address - Street 2:SUITE 820
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3157
Practice Address - Country:US
Practice Address - Phone:305-447-4150
Practice Address - Fax:305-448-8186
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS014320207Q00000X
FLOS10614207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine