Provider Demographics
NPI:1124756796
Name:BOBINEAUX, JOSHUA (DPT)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:BOBINEAUX
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 TORTOLA WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8514
Mailing Address - Country:US
Mailing Address - Phone:754-715-0402
Mailing Address - Fax:
Practice Address - Street 1:3313 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3606
Practice Address - Country:US
Practice Address - Phone:754-202-3457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT39218225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT39218OtherSTATE OF FLORIDA