MEDICARE: BRIAN HOCKENSMITH 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
1	207Q00000X	Family Medicine Physician	ARNP9208291	FL
2	363LA2200X	Adult Health Nurse Practitioner	R133985	MD
3	363LA2200X	Adult Health Nurse Practitioner	APRN9208291	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	:	1801893938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN HOCKENSMITH ARNP

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 400
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2051
Country	:	US
Telephone Number	:	813-654-7005
Fax Number	:	813-654-1050

Provider Business Practice Location Address
First Line	:	1944 SR 44
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168
Country	:	US
Telephone Number	:	386-428-3241
Fax Number	:	844-295-1379

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	11/29/2021

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