Healthcare Provider Details

I. General information

NPI: 1437870342
Provider Name (Legal Business Name): BRIAN JAMES HUGHES PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

IV. Provider business mailing address

6879 BELMAR DR
ORLANDO FL
32807-5095
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-8110
  • Fax:
Mailing address:
  • Phone: 518-791-4109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9116440
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: