Provider Demographics
NPI:1770887564
Name:FEIST, JOSEPH ROBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ROBERT
Last Name:FEIST
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4649 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2114
Mailing Address - Country:US
Mailing Address - Phone:305-667-1768
Mailing Address - Fax:305-667-1288
Practice Address - Street 1:4649 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2114
Practice Address - Country:US
Practice Address - Phone:305-667-1768
Practice Address - Fax:305-667-1288
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY2188103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74340OtherBLUE CROSS BLUE SHIELD OF FLORIDA