Healthcare Provider Details

I. General information

NPI: 1013423037
Provider Name (Legal Business Name): DARIN HOVIS ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 12/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 OLD 41 N UNIT 207
NAPLES FL
34110-8495
US

IV. Provider business mailing address

10803 ALVARA WAY
BONITA SPRINGS FL
34135-5390
US

V. Phone/Fax

Practice location:
  • Phone: 724-301-4285
  • Fax: 724-301-4285
Mailing address:
  • Phone: 724-301-4285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL3732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: