Provider Demographics
NPI:1720069362
Name:JOSEPH, RUFUS (MD)
Entity Type:Individual
Prefix:
First Name:RUFUS
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N STATE ROAD 7
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5853
Mailing Address - Country:US
Mailing Address - Phone:954-581-1977
Mailing Address - Fax:954-583-1667
Practice Address - Street 1:1600 N STATE ROAD 7
Practice Address - Street 2:SUITE 300
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-5853
Practice Address - Country:US
Practice Address - Phone:954-581-1977
Practice Address - Fax:954-583-1667
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME52086208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD16287Medicare UPIN