Provider Demographics
NPI:1366297665
Name:HHC PROVIDER SERVICES LLC
Entity type:Organization
Organization Name:HHC PROVIDER SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:941-264-9167
Mailing Address - Street 1:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:FELDA
Mailing Address - State:FL
Mailing Address - Zip Code:33930-0476
Mailing Address - Country:US
Mailing Address - Phone:941-264-9167
Mailing Address - Fax:
Practice Address - Street 1:2503 COUNTY ROAD 830
Practice Address - Street 2:
Practice Address - City:FELDA
Practice Address - State:FL
Practice Address - Zip Code:33930
Practice Address - Country:US
Practice Address - Phone:941-264-9167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty