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General NPI Number Information
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NPI Number | 1013944552
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Entity Type | Organization
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Legal Business Name | HYGEIA MEDICAL GROUP PA
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 1005 COLLEGE BLVD W SUITE C
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City | NICEVILLE
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State | FL
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Zip | 32578-1053
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Country | US
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Telephone | 850-678-3994
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Fax | 850-678-7131
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Provider Business Mailing Address
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Address Line | 1005 COLLEGE BLVD W SUITE C
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City | NICEVILLE
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State | FL
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Zip | 32578-1053
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Country | US
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Telephone | 850-678-3994
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Fax | 850-678-7131
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | VIRGINIA ANN ASTHANA
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Credential |
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Telephone | 850-897-3097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME30965
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License Number State | FL
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