Individual
MR. MARC BRYAN HULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1860 RENZULLI RD, NEW SMYRNA BEACH, FL 32168-1726
(386) 663-3061
(386) 663-3066
Mailing address
1860 RENZULLI RD, NEW SMYRNA BEACH, FL 32168-1726
(386) 663-3061
(386) 663-3066
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 9104001
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 9104001
PA LICENSE
FL
Enumeration date
01/05/2007
Last updated
07/18/2016
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