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NPI Code Detail

MEDICARE: PETER EDWARD HAKOS

MEDICARE: PETER EDWARD HAKOS
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 Assistant

General Provider Information

NPI Number : 1942611991
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER EDWARD HAKOS
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line : R30
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7751 BAYMEADOWS RD E STE 205
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-5836
Country : US
Telephone Number : 904-427-1050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2014
Last Update Date : 12/30/2025

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Directions to “ PETER EDWARD HAKOS ” Practice Location

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