Joe South, PA-C
Physician Assistant in Tampa, FL. Individual provider (NPI-1).
NPI number1982168118
StatusActive
Last updated in NPPESJan 22, 2019
Details
- NPI
- 1982168118
- Entity type
- Individual (NPI-1)
- Name
- Mr. Joe South
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 22, 2019
- Last updated
- Jan 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 9111972 | FL | Yes |
Practice location
2502 W Saint Isabel St Ste BTampa, FL 33607-6318
Phone 813-874-5707
Mailing address
411 N Federal Hwy Apt 408Hallandale Beach, FL 33009-3483
Phone 352-431-0989
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