Provider Demographics
NPI:1992137277
Name:GHULAM, JOSELYN (APN)
Entity type:Individual
Prefix:MS
First Name:JOSELYN
Middle Name:
Last Name:GHULAM
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 BENMORE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4111
Mailing Address - Country:US
Mailing Address - Phone:407-646-7070
Mailing Address - Fax:407-646-7747
Practice Address - Street 1:133 BENMORE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4111
Practice Address - Country:US
Practice Address - Phone:407-646-7070
Practice Address - Fax:407-646-7747
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17854363LF0000X
FLARNP 9402091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily