Healthcare Provider Details

I. General information

NPI: 1952617847
Provider Name (Legal Business Name): JEANNINE HOSKING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KINGSHYRE WAY
TAMPA FL
33647-2874
US

IV. Provider business mailing address

10010 KINGSHYRE WAY
TAMPA FL
33647-2874
US

V. Phone/Fax

Practice location:
  • Phone: 813-532-1382
  • Fax:
Mailing address:
  • Phone: 813-532-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: