Provider Demographics
NPI:1538755046
Name:CENTER FOR JOINT HEALTH, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:CENTER FOR JOINT HEALTH, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARNESI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-857-9747
Mailing Address - Street 1:10232 BRIGHT CRYSTAL AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4287
Mailing Address - Country:US
Mailing Address - Phone:412-801-2236
Mailing Address - Fax:
Practice Address - Street 1:10420 S US 301 STE 2
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5806
Practice Address - Country:US
Practice Address - Phone:412-801-2236
Practice Address - Fax:813-274-1946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty