Joseph, Reginald

Joseph, Reginald is an individual health care provider with primary practice located at 1223 Gateway Dr Suite 1E, Melbourne FL 32901. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Joseph, Reginald can be contacted via phone (321) 725-4505.

Contact Information

Primary practice address
1223 Gateway Dr Suite 1E Melbourne FL 32901
Phone: (321) 725-4505
Fax: (321) 409-8932
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9106973 Florida

Profile Details

NPI number 1861737439
LBN Legal business name Joseph, Reginald
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2012
Last updated Jun 22nd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861737439 NPPES
Florida Other GW561V MEDICARE
Florida MEDICAID PENDING MEDICARE

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