Provider Demographics
NPI:1386115400
Name:DOYLE, JOSEPH (RPH, MBA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:DOYLE
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NE 33RD AVE APT 5K
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1878
Mailing Address - Country:US
Mailing Address - Phone:908-872-3639
Mailing Address - Fax:
Practice Address - Street 1:234 COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-4438
Practice Address - Country:US
Practice Address - Phone:954-938-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS27317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist