Healthcare Provider Details

I. General information

NPI: 1619420551
Provider Name (Legal Business Name): PETER JAMES HUTCHISON AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 09/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9156 SEMINOLE BLVD
SEMINOLE FL
33772-3148
US

IV. Provider business mailing address

7802 LEMONWOOD CT
TEMPLE TERRACE FL
33637-6535
US

V. Phone/Fax

Practice location:
  • Phone: 727-393-3775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2064
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: