Individual
JAMES HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AG-ANCP-BC
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-4225
Mailing address
2609 AMATI DRIVE, KISSIMMEE, FL 34741
(410) 608-5376
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
008372
CT
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN9461696
FL
363LA2100X
Acute Care Nurse Practitioner
ARNP9461696
FL
363LA2100X
Acute Care Nurse Practitioner
LP-0000348
DE
363LA2100X
Acute Care Nurse Practitioner
R192286
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008372
CT LIC
CT
05
—
022631800
—
FL
01
—
P2257
MEDICARE HF
FL
Enumeration date
09/21/2016
Last updated
11/10/2022
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