Provider Demographics
NPI:1487782769
Name:HUGHES, NATASHA (MD)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10549
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-0549
Mailing Address - Country:US
Mailing Address - Phone:727-544-2284
Mailing Address - Fax:727-541-7984
Practice Address - Street 1:1020 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3423
Practice Address - Country:US
Practice Address - Phone:727-461-1439
Practice Address - Fax:727-443-7230
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN8141208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27866640Medicaid
FLAL047ZMedicare PIN