Healthcare Provider Details

I. General information

NPI: 1124837679
Provider Name (Legal Business Name): VICTORIA HOGANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 UNIVERSITY BLVD N
JACKSONVILLE FL
32211-3321
US

IV. Provider business mailing address

15480 TURKOMAN CIR
JACKSONVILLE FL
32218-7978
US

V. Phone/Fax

Practice location:
  • Phone: 904-256-8000
  • Fax:
Mailing address:
  • Phone: 904-304-8797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11033117
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: