Individual
ANTON HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1012 LUCERNE TER, ORLANDO, FL 32806-1015
(474) 423-1039
(407) 425-2347
Mailing address
1012 LUCERNE TER, ORLANDO, FL 32806-1015
(474) 423-1039
(407) 425-2347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
PA9120518
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366093031
N/A
CA
Enumeration date
09/24/2019
Last updated
11/13/2025
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