MEDICARE: MISTY MEI HOBBS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	ME151843	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225696719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISTY MEI HOBBS MD

Provider Business Mailing Address
First Line	:	18228 N US HIGHWAY 41
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33549-4400
Country	:	US
Telephone Number	:	813-321-1786
Fax Number	:	813-321-1787

Provider Business Practice Location Address
First Line	:	3200 3RD ST S STE 200
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-6097
Country	:	US
Telephone Number	:	813-321-1786
Fax Number	:	813-321-1787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	08/07/2024

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