Individual
HAZELINE KATHERINE MCCABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1361 13TH AVE S, STE 150, JACKSONVILLE BEACH, FL 32250-3233
(904) 242-7177
(904) 242-7433
Mailing address
PO BOX 44008, UFJP - PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105029
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013180-00
—
FL
Enumeration date
07/30/2009
Last updated
03/14/2016
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