Provider Demographics
NPI:1861422297
Name:LEE, HEATHER HOBBS (PA-C)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:HOBBS
Last Name:LEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:HOBBS
Other - Last Name:JENNINGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:23476 NW 186TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-0673
Mailing Address - Country:US
Mailing Address - Phone:386-454-0698
Mailing Address - Fax:386-454-0690
Practice Address - Street 1:16916 NW US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-8102
Practice Address - Country:US
Practice Address - Phone:386-454-0568
Practice Address - Fax:352-224-7899
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101298363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292277100Medicaid
FLPA9101298OtherFLORIDA LICENSE NUMBER
FL292277100Medicaid
FLPA9101298OtherFLORIDA LICENSE NUMBER
U6232Medicare PIN