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NPI Code Detail

MEDICARE: DONALD J HUGGARD PA

MEDICARE:   DONALD J HUGGARD  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
1363A00000XPhysician AssistantPA3292FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2IB111ZOTHERFLMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001658OTHERFLFLORIDA HEALTH CARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700870177
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD J HUGGARD PA
Provider Business Mailing Address
First Line : 2950 SUNSET DR
Second Line :
City : NEW SMYRNA BEACH
State : FL
Zip : 32168-5616
Country : US
Telephone Number : 386-871-5708
Fax Number :
Provider Business Practice Location Address
First Line : 812 W INDIAN BLVD.
Second Line :
City : EDGEWATER
State : FL
Zip : 32132-3429
Country : US
Telephone Number : 386-426-1411
Fax Number : 386-426-1411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 04/23/2015

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Directions to “ DONALD J HUGGARD PA” Practice Location

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