Healthcare Provider Details

I. General information

NPI: 1760738538
Provider Name (Legal Business Name): JULIE STEPHANIE HINOJOSA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE STEPHANIE HINOJOSA PA-C

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11528 US HWY 19
PORT RICHEY FL
34668-1442
US

IV. Provider business mailing address

11528 US HWY 19
PORT RICHEY FL
34668-1442
US

V. Phone/Fax

Practice location:
  • Phone: 727-868-2151
  • Fax: 727-869-0732
Mailing address:
  • Phone: 727-868-2151
  • Fax: 727-869-0732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9106635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: