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General NPI Number Information
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NPI Number | 1942611991
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Entity Type | Individual
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Provider Name | PETER EDWARD HAKOS
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Gender | Male
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Dates
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Enumeration Date | 05/13/2014
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 7751 BAYMEADOWS RD E STE 205
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City | JACKSONVILLE
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State | FL
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Zip | 32256-5836
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Country | US
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Telephone | 904-427-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 9500 EUCLID AVE R30
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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