Joseph J Daversa Jr MD PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME 0014994 Issued in FL

Legal business name

JOSEPH J DAVERSA JR MD PA

Practice address

12368 SW 82ND Ave
Miami, FL 33156-5223

Phone

(305) 253-4218

Fax

(305) 233-5844

NPI assigned

Feb 23, 2006

Last updated

Mar 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph James Daversa Jr., MDNPI 1649246455

Title

President

Phone

(305) 253-4218

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph James Daversa Jr., MD

  • Child & Adolescent Psychiatry Physician
  • Miami, FL
  • NPI 1649246455
  Authorized official Same address or phone

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1952377764",
    "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": {
        "organization_name": "JOSEPH J DAVERSA JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "DAVERSA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-253-4218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 0014994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049162400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joseph Kilshtok DDS PA (Port Of Miami Dental)
• Joseph Kurstin MD PA (Laser Eye Center of Miami, LLC)
• Joseph P McCain DMD PA
• Joseph Rehab, Corp
• Joseph Services, Inc.

• Psychiatry Physician in Miami, FL
• Providers in Miami, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.