Provider Demographics
NPI:1649920190
Name:HAGGENMACHER, JOSHUA ANDREAS JENO (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ANDREAS JENO
Last Name:HAGGENMACHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 W COMMERCIAL BLVD STE 5100
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3055
Mailing Address - Country:US
Mailing Address - Phone:954-730-9300
Mailing Address - Fax:
Practice Address - Street 1:2101 W COMMERCIAL BLVD STE 5100
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3055
Practice Address - Country:US
Practice Address - Phone:954-730-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-27
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME175084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine