Provider Demographics
NPI:1194709238
Name:JAHRAUS, JOEL P (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:P
Last Name:JAHRAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6150 SW 76TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5002
Mailing Address - Country:US
Mailing Address - Phone:305-663-1738
Mailing Address - Fax:305-663-7281
Practice Address - Street 1:6150 SW 76TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5002
Practice Address - Country:US
Practice Address - Phone:305-663-1738
Practice Address - Fax:305-663-7281
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN26405207Q00000X
FLME113171207Q00000X
AZ30620207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D25979Medicare UPIN