Healthcare Provider Details

I. General information

NPI: 1568270742
Provider Name (Legal Business Name): ANDREA HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 MOHAWK RD
MINNEOLA FL
34715-7433
US

IV. Provider business mailing address

236 MOHAWK RD
MINNEOLA FL
34715-7433
US

V. Phone/Fax

Practice location:
  • Phone: 352-404-6908
  • Fax: 352-404-6909
Mailing address:
  • Phone: 352-404-6908
  • Fax: 352-404-6909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA88648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: