Healthcare Provider Details

I. General information

NPI: 1336740463
Provider Name (Legal Business Name): ASHLEY MARIE HEBDA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2020
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 VILAGE SQUARE CROSSING SUITE #202
PALM BEACH GARDENS FL
33410
US

IV. Provider business mailing address

9386 FOXGLOVE LN
NAPLES FL
34120-5491
US

V. Phone/Fax

Practice location:
  • Phone: 561-473-4302
  • Fax:
Mailing address:
  • Phone: 219-776-2399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9112623
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: