Healthcare Provider Details

I. General information

NPI: 1679138689
Provider Name (Legal Business Name): HUGHES DIRECT PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2019
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9351 CORKSCREW RD STE 101
ESTERO FL
33928-6801
US

IV. Provider business mailing address

9351 CORKSCREW RD STE 101
ESTERO FL
33928-6801
US

V. Phone/Fax

Practice location:
  • Phone: 239-278-1155
  • Fax: 239-278-1159
Mailing address:
  • Phone: 239-278-1155
  • Fax: 239-278-1159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOY TOMLINSON
Title or Position: BILLING
Credential:
Phone: 239-278-1155