Healthcare Provider Details

I. General information

NPI: 1740295468
Provider Name (Legal Business Name): HANS E. HUBSCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11904 MIRAMAR PKWY
MIRAMAR FL
33025-7005
US

IV. Provider business mailing address

11904 MIRAMAR PKWY
MIRAMAR FL
33025-7005
US

V. Phone/Fax

Practice location:
  • Phone: 954-704-1051
  • Fax: 954-437-0526
Mailing address:
  • Phone: 954-704-1051
  • Fax: 954-437-0526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME82436
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: