Provider Demographics
NPI:1972698959
Name:HUBSHER HEALTHCARE, P.A.
Entity type:Organization
Organization Name:HUBSHER HEALTHCARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBSHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-844-7077
Mailing Address - Street 1:6545 RIDGE ROAD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668
Mailing Address - Country:US
Mailing Address - Phone:727-844-7077
Mailing Address - Fax:727-847-6919
Practice Address - Street 1:6545 RIDGE ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668
Practice Address - Country:US
Practice Address - Phone:727-844-7077
Practice Address - Fax:727-847-6919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0054777207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1441Medicare ID - Type UnspecifiedMEDICARE
FLF20644Medicare UPIN