Provider Demographics
NPI:1215749668
Name:JOSEPH, MIMOSE L (RN)
Entity type:Individual
Prefix:MS
First Name:MIMOSE
Middle Name:L
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 FOREST HILL BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5617
Mailing Address - Country:US
Mailing Address - Phone:561-909-8555
Mailing Address - Fax:747-220-0351
Practice Address - Street 1:3600 FOREST HILL BLVD STE 3
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5617
Practice Address - Country:US
Practice Address - Phone:561-909-8555
Practice Address - Fax:747-220-0351
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9669206163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse