Provider Demographics
NPI:1386940757
Name:HUGHES FAMILY PRACTICE PL
Entity type:Organization
Organization Name:HUGHES FAMILY PRACTICE PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-561-5776
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33929-0449
Mailing Address - Country:US
Mailing Address - Phone:239-561-5776
Mailing Address - Fax:239-333-1953
Practice Address - Street 1:13731 METROPOLIS AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-7150
Practice Address - Country:US
Practice Address - Phone:239-561-5776
Practice Address - Fax:239-333-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9442207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04014OtherBC/BS OF FL