Basic Information
Provider Information
NPI: 1336175827
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SERA-JOSEF
FirstName: JOY
MiddleName: TUZON
NamePrefix: MRS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 15026 SW 22ND ST
Address2:  
City: MIRAMAR
State: FL
PostalCode: 330274368
CountryCode: US
TelephoneNumber: 3056289556
FaxNumber: 9056289493
Practice Location
Address1: 16555 NW 25TH AVE
Address2:  
City: OPA LOCKA
State: FL
PostalCode: 330546583
CountryCode: US
TelephoneNumber: 7864661732
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP2300XARNP 1436332FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care

No ID Information.


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