Basic Information
Provider Information | |||||||||
NPI: | 1043208598 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SAVITCH | ||||||||
FirstName: | JOEL | ||||||||
MiddleName: | ROBERT | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | ARNP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1700 NW 70TH LN | ||||||||
Address2: |   | ||||||||
City: | MARGATE | ||||||||
State: | FL | ||||||||
PostalCode: | 330632436 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9549935635 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 1065 NE 125TH STREET | ||||||||
Address2: | SUITE 206 | ||||||||
City: | NORTH MIAMI | ||||||||
State: | FL | ||||||||
PostalCode: | 331615832 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3058910050 | ||||||||
FaxNumber: | 3055037363 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/10/2005 | ||||||||
LastUpdateDate: | 03/15/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | ARNP980072 | FL | N |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LG0600X | ARNP980072 | FL | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 364SA2200X | ARNP980072 | FL | N |   | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health | 364SG0600X | ARNP980072 | FL | N |   | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Gerontology |
No ID Information.