Individual
DR. MARY ANN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10141 BIG BEND RD STE 103, RIVERVIEW, FL 33578-7421
(813) 302-8740
(813) 605-6060
Mailing address
2995 DREW ST, CLEARWATER, FL 33759-3012
(727) 315-7496
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME88392
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268120000
—
FL
Enumeration date
01/13/2006
Last updated
06/13/2024
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