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Individual

DR. VICENTA MARIBEL HAWKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
701 6TH ST S, ST PETERSBURG, FL 33701-4814
(727) 823-1234
Mailing address
1530 CORNERSTONE BLVD, SUITE 200, DAYTONA, FL 32117
(386) 274-7800
(386) 274-7801

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS9189
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
212699
AMERIGROUP
FL
05
272885100
FL
01
29520
BLUE CROSS OF FLORIDA
FL
Enumeration date
06/25/2006
Last updated
10/10/2013
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