Provider Demographics
NPI:1386929602
Name:JOSEPH, MARSHA
Entity type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5902 LAKE POINTE VILLAGE CIR
Mailing Address - Street 2:APT 317
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3576
Mailing Address - Country:US
Mailing Address - Phone:407-253-6288
Mailing Address - Fax:
Practice Address - Street 1:920 S KIRKMAN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-2203
Practice Address - Country:US
Practice Address - Phone:407-253-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44483183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist