Provider Demographics
NPI:1417772880
Name:DA COSTA MESQUITA, JOYCE
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:DA COSTA MESQUITA
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 1:22169 CRESSMONT PL FL 33428
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4280
Mailing Address - Country:US
Mailing Address - Phone:561-463-8441
Mailing Address - Fax:
Practice Address - Street 1:22169 CRESSMONT PL FL 33428
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-4280
Practice Address - Country:US
Practice Address - Phone:561-463-8441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician