Provider Demographics
NPI:1396550059
Name:JOSEPH, ISMAIL FARID
Entity type:Individual
Prefix:
First Name:ISMAIL
Middle Name:FARID
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 NORMANDY DR
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-8891
Mailing Address - Country:US
Mailing Address - Phone:786-469-0178
Mailing Address - Fax:
Practice Address - Street 1:1338 NORMANDY DR
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-8891
Practice Address - Country:US
Practice Address - Phone:786-469-0178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services