Provider Demographics
NPI:1104880921
Name:LIGHT, JOSHUA P (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:P
Last Name:LIGHT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:900 NW 13TH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2350
Mailing Address - Country:US
Mailing Address - Phone:561-391-3333
Mailing Address - Fax:561-391-5618
Practice Address - Street 1:1800 W WOOLBRIGHT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6398
Practice Address - Country:US
Practice Address - Phone:561-737-8584
Practice Address - Fax:561-737-5703
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2022-12-08
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Provider Licenses
StateLicense IDTaxonomies
FLME0081501207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58534XMedicare ID - Type Unspecified
FLH45319Medicare UPIN