Provider Demographics
NPI:1003498411
Name:HOBBS-TUCK, NATALIA QUINZELLA
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:QUINZELLA
Last Name:HOBBS-TUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 BUCKRUN DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7300
Mailing Address - Country:US
Mailing Address - Phone:440-773-0525
Mailing Address - Fax:
Practice Address - Street 1:3203 BUCKRUN DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7300
Practice Address - Country:US
Practice Address - Phone:440-773-0525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-25
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X
FL389270251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty