Healthcare Provider Details

I. General information

NPI: 1265250625
Provider Name (Legal Business Name): MISS HOPE J PACE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 POYDRAS ST STE 1400
NEW ORLEANS LA
70130-6116
US

IV. Provider business mailing address

9300 CONROY WINDERMERE RD UNIT 1165
WINDERMERE FL
34786-5047
US

V. Phone/Fax

Practice location:
  • Phone: 888-392-0555
  • Fax:
Mailing address:
  • Phone: 407-922-2994
  • 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: