Individual
DR. JOSHUA GILMAN HACKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 GULF BREEZE PKWY, SUITE 200, GULF BREEZE, FL 32561-7809
(850) 916-3700
(850) 916-3710
Mailing address
1040 GULF BREEZE PKWY STE 200, GULF BREEZE, FL 32561-7808
(850) 916-3700
(850) 916-3710
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME 91174
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110611
—
AL
05
—
273585700
—
FL
01
—
50284
BLUE CROSS BLUE SHIELD
FL
01
—
591-82235
BLUE CROSS BLUE SHIELD
AL
Enumeration date
08/18/2005
Last updated
01/24/2019
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