Provider Demographics
NPI:1083641070
Name:HANCOCK, MICHAEL T (ARNP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8425 NORTHCLIFFE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1107
Mailing Address - Country:US
Mailing Address - Phone:352-688-6346
Mailing Address - Fax:352-688-9103
Practice Address - Street 1:8425 NORTHCLIFFE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1107
Practice Address - Country:US
Practice Address - Phone:352-688-6346
Practice Address - Fax:352-688-9103
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9193975363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY036TOtherBCBS
FL012908000Medicaid
P00168707OtherRAILROAD MEDICARE