MEDICARE: KARSON NICOLE HOAGLAND PA

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
1	363A00000X	Physician Assistant	PAT9114886	FL
2	363A00000X	Physician Assistant	63814	CA
3	363A00000X	Physician Assistant	PA9114886	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336818517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARSON NICOLE HOAGLAND PA

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR STE 1900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4771 S CLEVELAND AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1317
Country	:	US
Telephone Number	:	239-343-9800
Fax Number	:	239-343-9848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2021
Last Update Date	:	01/20/2026

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Directions to “ KARSON NICOLE HOAGLAND PA” Practice Location

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