Daversa, Joseph James

Daversa, Joseph James is an sole proprietor health care provider with primary practice located at 12368 Sw 82Nd Ave , Miami FL 33156-5223. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Daversa, Joseph James can be contacted via phone (305) 253-4218.

Contact Information

Primary practice address
12368 Sw 82Nd Ave Miami FL 33156-5223
Phone: (305) 253-4218
Fax: (305) 233-5844
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME 0014994 Florida
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X ME 0014994 Florida

Profile Details

NPI number 1649246455
LBN Legal business name Daversa, Joseph James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2006
Last updated Mar 29th, 2011 - about 14 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 1649246455 NPPES
Florida MEDICAID 049162400

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