Healthcare Provider Details

I. General information

NPI: 1689530628
Provider Name (Legal Business Name): PAUL JOSEPH HAWKES III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE 17TH ST STE 801
OCALA FL
34471-4182
US

IV. Provider business mailing address

1470 SW 101ST TER APT 106
PEMBROKE PINES FL
33025-5014
US

V. Phone/Fax

Practice location:
  • Phone: 352-425-4280
  • Fax: 352-540-7729
Mailing address:
  • Phone: 305-608-1217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5209
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: