Provider Demographics
NPI:1740459924
Name:JOSHUA RYCUS DO
Entity type:Organization
Organization Name:JOSHUA RYCUS DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-753-1477
Mailing Address - Street 1:9750 NW 33RD ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4042
Mailing Address - Country:US
Mailing Address - Phone:954-753-1477
Mailing Address - Fax:954-753-3626
Practice Address - Street 1:9750 NW 33RD ST
Practice Address - Street 2:SUITE 114
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4042
Practice Address - Country:US
Practice Address - Phone:954-753-1477
Practice Address - Fax:954-753-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 8863207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL48268OtherMEDICARE
FL48268OtherBCBS
FL1758777001OtherCIGNA
FL269335600Medicaid
FL3608139OtherAETNA
FL50806OtherNEIGHBORHOOD
FL295499OtherAVMED
FL101381OtherUNITEDHEALTHCARE
FL1047954OtherCAREPLUS
FLI13209Medicare UPIN