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General NPI Number Information
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NPI Number | 1932588050
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Entity Type | Organization
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Legal Business Name | JAMES J. HYNICK, D.O., P.A.
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | 301 E STATE ROAD 434
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City | LONGWOOD
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State | FL
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Zip | 32750-5217
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Country | US
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Telephone | 407-339-3524
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Fax | 407-339-3832
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Provider Business Mailing Address
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Address Line | 301 E STATE ROAD 434
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City | LONGWOOD
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State | FL
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Zip | 32750-5217
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Country | US
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Telephone | 407-339-3524
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Fax | 407-339-3832
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES J HYNICK
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Credential | D.O.
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Telephone | 407-339-3524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS3683
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License Number State | FL
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