Healthcare Provider Details
I. General information
NPI: 1568593648
Provider Name (Legal Business Name): LENARD M HUGHES MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/08/2007
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 45TH ST
WEST PALM BEACH FL
33407-2413
US
IV. Provider business mailing address
15471 TEMPLE BLVD
LOXAHATCHEE FL
33470-3130
US
V. Phone/Fax
- Phone: 561-844-6300
- Fax: 561-792-5096
- Phone: 561-792-5096
- Fax: 561-792-5096
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | ME68396 |
| License Number State | FL |
VIII. Authorized Official
Name:
LENARD
M
HUGHES
Title or Position: PRESIDENT
Credential: MD
Phone: 561-792-5096