Organization
NORTHWEST FLORIDA GERIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI M HODSON ARNP (SOLE MBR)
(850) 384-8969
Entity
Organization
Contact information
Practice address
5530 NORTHROP RD, MILTON, FL 32570-8701
(850) 983-8888
Mailing address
5997 CHERRY HILL CIR, PACE, FL 32571-9382
(850) 384-8969
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101613300
—
FL
Enumeration date
11/19/2018
Last updated
07/27/2022
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