Healthcare Provider Details
I. General information
NPI: 1699692897
Provider Name (Legal Business Name): MADISON ELIZABETH HOOK DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1150 JACARANDA BLVD
VENICE FL
34292
US
IV. Provider business mailing address
3004 W FAIR OAKS AVE
TAMPA FL
33611-1641
US
V. Phone/Fax
- Phone: 813-442-9089
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 31735 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: