Healthcare Provider Details

I. General information

NPI: 1548377435
Provider Name (Legal Business Name): DAVID ALLEN HOTCHKISS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 06/17/2023
Certification Date: 06/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4161 TAMIAMI TRL STE 701
PORT CHARLOTTE FL
33952-9283
US

IV. Provider business mailing address

4161 TAMIAMI TRL STE 701
PORT CHARLOTTE FL
33952-9283
US

V. Phone/Fax

Practice location:
  • Phone: 941-629-5356
  • Fax: 941-629-4987
Mailing address:
  • Phone: 941-629-5356
  • Fax: 941-629-4987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME81967
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME81967
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: