| Joseph J Daversa Jr Md Pa | |
|
12368 Sw 82nd Ave Miami FL 33156-5223 | |
| (305) 253-4218 | |
| (305) 233-5844 |
| Full Name | Joseph J Daversa Jr Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 12368 Sw 82nd Ave, Miami, Florida |
| Authorized Official Name and Position | Joseph James Daversa (PRESIDENT) |
| Authorized Official Contact | 3052534218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph J Daversa Jr Md Pa 12368 Sw 82nd Ave Miami FL 33156-5223 Ph: (305) 253-4218 | Joseph J Daversa Jr Md Pa 12368 Sw 82nd Ave Miami FL 33156-5223 Ph: (305) 253-4218 |
| NPI Number | 1952377764 |
|---|---|
| Provider Enumeration Date | 02/23/2006 |
| Last Update Date | 03/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952377764 | NPI | - | NPPES |
| 049162400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME 0014994 (Florida) | Primary |
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