Provider Demographics
NPI:1154588333
Name:DAREN JOSEPH DC PA
Entity type:Organization
Organization Name:DAREN JOSEPH DC PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-455-2030
Mailing Address - Street 1:800 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4477
Mailing Address - Country:US
Mailing Address - Phone:954-455-2030
Mailing Address - Fax:954-455-2040
Practice Address - Street 1:800 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 14
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4477
Practice Address - Country:US
Practice Address - Phone:954-455-2030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5711AMedicare PIN