Healthcare Provider Details

I. General information

NPI: 1558488643
Provider Name (Legal Business Name): WENDY LYNN HOAG M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 7TH AVE N
ST PETERSBURG FL
33701-2316
US

IV. Provider business mailing address

6404 SUTHERLAND AVE
NEW PORT RICHEY FL
34653-1017
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-5434
  • Fax:
Mailing address:
  • Phone: 727-846-0527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: