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NPI Code Detail

MEDICARE: JOSEPH HIBBARD CRNA, ARNP

MEDICARE:   JOSEPH  HIBBARD  CRNA, ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician039730FL

Other Identifiers

General Provider Information

NPI Number : 1326089772
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH HIBBARD CRNA, ARNP
Provider Business Mailing Address
First Line : PO BOX 561600
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32956-1600
Country : US
Telephone Number : 321-434-4600
Fax Number : 321-259-0635
Provider Business Practice Location Address
First Line : 1425 MALABAR RD NE
Second Line :
City : PALM BAY
State : FL
Zip : 32907-2506
Country : US
Telephone Number : 321-434-8025
Fax Number : 321-434-8075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 05/18/2012

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