Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN11008100 | FL |
NPI | 1629686878 |
---|---|
Provider Name | Mr. Eric Daniel Hinojosa |
First Address | Valparaiso, FL 32580-1510 |
Second Address | Fort Walton Beach, FL 32547-6708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2020 |
Last Update Date | 14/07/2020 |