Provider Demographics
NPI:1912736554
Name:FALCON, JOY
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:FALCON
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 1:1907 N US HIGHWAY 301 STE 150
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-2601
Mailing Address - Country:US
Mailing Address - Phone:860-983-6882
Mailing Address - Fax:
Practice Address - Street 1:1907 N US HIGHWAY 301 BLDG C
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-2641
Practice Address - Country:US
Practice Address - Phone:860-983-6882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health