Provider Demographics
NPI:1841293289
Name:JOSEY, MARY LEE (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:LEE
Last Name:JOSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:508 S HABANA AVE
Mailing Address - Street 2:STE 350
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4181
Mailing Address - Country:US
Mailing Address - Phone:813-873-1426
Mailing Address - Fax:813-873-1824
Practice Address - Street 1:508 S HABANA AVE
Practice Address - Street 2:STE 350
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4181
Practice Address - Country:US
Practice Address - Phone:813-873-1426
Practice Address - Fax:813-873-1824
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0053792207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07663Medicare ID - Type Unspecified
FLE30541Medicare UPIN