Healthcare Provider Details

I. General information

NPI: 1952060162
Provider Name (Legal Business Name): WILLIAM R HUTSON JR. RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 12/15/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 S SEMORAN BLVD
WINTER PARK FL
32792-5313
US

IV. Provider business mailing address

375 CAPTAIN THOMAS BLVD UNIT 32
WEST HAVEN CT
06516-5877
US

V. Phone/Fax

Practice location:
  • Phone: 407-961-6561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: