Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS17667 | FL |
N | 207Q00000X | Family Doctor | TL.0007293 | CO |
NPI | 1003306424 |
---|---|
Provider Name | Trista F Hughes |
First Address | Winter Park, FL 32792-4111 |
Second Address | Winter Park, FL 32792-4111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2018 |
Last Update Date | 27/08/2021 |