Healthcare Provider Details

I. General information

NPI: 1215742226
Provider Name (Legal Business Name): MRS. MIESHA YVETTE HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2025
Last Update Date: 02/08/2025
Certification Date: 02/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2783 CHESTERBROOK CT
JACKSONVILLE FL
32224-4851
US

IV. Provider business mailing address

2783 CHESTERBROOK CT
JACKSONVILLE FL
32224-4851
US

V. Phone/Fax

Practice location:
  • Phone: 904-233-9397
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA80414
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: