Provider Demographics
NPI:1427638352
Name:JOSEPH, DARIEN LAVOY
Entity type:Individual
Prefix:
First Name:DARIEN
Middle Name:LAVOY
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 1:2569 PONKAN SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-6415
Mailing Address - Country:US
Mailing Address - Phone:321-960-7362
Mailing Address - Fax:
Practice Address - Street 1:2569 PONKAN SUMMIT DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-6415
Practice Address - Country:US
Practice Address - Phone:321-960-7362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-05-24
Deactivation Date:2021-05-24
Deactivation Code:
Reactivation Date:2021-05-24
Provider Licenses
StateLicense IDTaxonomies
FLRN9190043163WH0200X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL86-2767155Medicaid