Joseph James Daversa Jr., MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

ME 0014994 Issued in FL

Practice address

12368 SW 82ND Ave
Miami, FL 33156-5223

Phone

(305) 253-4218

Fax

(305) 233-5844

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1649246455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12368 SW 82ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565223",
            "telephone_number": "305-253-4218",
            "fax_number": "305-233-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12368 SW 82ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565223",
            "telephone_number": "305-253-4218",
            "fax_number": "305-233-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVERSA",
        "first_name": "JOSEPH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 0014994",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME 0014994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049162400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roberto Sebastian Davalos
• Danielle Marie Davault
• Heeransh Dharmesh Dave, M.D.
• Sandeep P Dave, M.D
• Claudia Daveiga Peron
• Richard C Davi, MD
• Davi'S Alf, Inc.
• David Aaron Ross MD LLC
• David E Gonzalez DDS PA
• David E. Wells, M.D. P.a.

• Child & Adolescent Psychiatry Physician in Miami, FL
• Providers in Miami, FL by specialty
• Child & Adolescent Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.