Provider Demographics
NPI:1952404022
Name:JOSEPH, DAVID V (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:V
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 1:793 HEALTH CARE DRIVE
Mailing Address - Street 2:STE 103
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763
Mailing Address - Country:US
Mailing Address - Phone:386-753-0505
Mailing Address - Fax:386-753-0338
Practice Address - Street 1:793 HEALTH CARE DRIVE
Practice Address - Street 2:STE 103
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763
Practice Address - Country:US
Practice Address - Phone:386-753-0505
Practice Address - Fax:386-753-0338
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60865207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41506Medicare ID - Type Unspecified
E16122Medicare UPIN