Provider Demographics
NPI:1043456304
Name:JOYNER THERAPY
Entity type:Organization
Organization Name:JOYNER THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE-ANNE
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:JOYNER-ROBICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-216-3572
Mailing Address - Street 1:525 S HERCULES AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6320
Mailing Address - Country:US
Mailing Address - Phone:727-216-3572
Mailing Address - Fax:727-216-3573
Practice Address - Street 1:525 S HERCULES AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6320
Practice Address - Country:US
Practice Address - Phone:727-216-3572
Practice Address - Fax:727-216-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6101174400000X
FLSA6015174400000X
FLSA7843174400000X
FLSA4711174400000X
FLOT5993174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL886414400Medicaid
FL888334300Medicaid
FL891280700Medicaid
FL891394300Medicaid
FL887150700Medicaid