1548209109 NPI number — DR. JOSHUA M HARE MD, FACC, FAHA

Table of content: DR. JOSHUA M HARE MD, FACC, FAHA (NPI 1548209109)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548209109 NPI number — DR. JOSHUA M HARE MD, FACC, FAHA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARE
Provider First Name:
JOSHUA
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, FACC, FAHA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548209109
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 NW 12TH AVENUE
Provider Second Line Business Mailing Address:
JMT EAST 1007
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33136-1028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-243-4664
Provider Business Mailing Address Fax Number:
305-243-9927

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 NW 12TH AVENUE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33136-1003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-243-1900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  D48124 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: ME0098656 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2783541-00 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 692521900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: ME0098656 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 8E294 . This is a "MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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