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NPI Code Detail

MEDICARE: MR. MICHAEL RYAN HOARD PA-C

MEDICARE: MR. MICHAEL RYAN HOARD PA-C
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
1363AM0700XMedical Physician AssistantPA9112164FL

Other Identifiers

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

General Provider Information

NPI Number : 1710541065
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL RYAN HOARD PA-C
Provider Business Mailing Address
First Line : 2202 N LOIS AVE APT 2302
Second Line :
City : TAMPA
State : FL
Zip : 33607-2575
Country : US
Telephone Number : 312-909-1028
Fax Number :
Provider Business Practice Location Address
First Line : 3345 S DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33629-7817
Country : US
Telephone Number : 813-234-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2019
Last Update Date : 04/23/2019

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