Provider Demographics
NPI:1851309652
Name:JOSHI, S K (MD, PA)
Entity type:Individual
Prefix:DR
First Name:S
Middle Name:K
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1051
Mailing Address - Country:US
Mailing Address - Phone:407-323-9570
Mailing Address - Fax:407-330-4777
Practice Address - Street 1:1001 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1051
Practice Address - Country:US
Practice Address - Phone:407-323-9570
Practice Address - Fax:407-330-4777
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30688174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL408113034OtherMEDICARE RAILROAD
FL059126200Medicaid
FL79095YMedicare PIN
FL059126200Medicaid