Provider Demographics
NPI:1699172999
Name:GRATTON, JOSHUA MAURICE (CSFA, OA-C, ATC)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:MAURICE
Last Name:GRATTON
Suffix:
Gender:M
Credentials:CSFA, OA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2353 NW 139TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-5331
Mailing Address - Country:US
Mailing Address - Phone:954-304-7466
Mailing Address - Fax:
Practice Address - Street 1:2353 NW 139TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-5331
Practice Address - Country:US
Practice Address - Phone:954-304-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL32072255A2300X
246ZC0007X, 246ZX2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant