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Individual

EDDIE C HUBBARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7511 JOHN MATTHEWS RD, MILTON, FL 32583-3401
(850) 516-3039
(850) 623-1181
Mailing address
7511 JOHN MATTHEWS RD, MILTON, FL 32583-3401
(850) 516-3039
(850) 623-1181

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
CNA27456
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
673797879
FL
Enumeration date
06/13/2012
Last updated
06/13/2012
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