Provider Demographics
NPI:1194014571
Name:HUNT, JOSEPHINE HAZELTON
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:HAZELTON
Last Name:HUNT
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 1:1590 E HOOKER ST
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-6032
Mailing Address - Country:US
Mailing Address - Phone:863-519-3436
Mailing Address - Fax:863-519-6487
Practice Address - Street 1:1590 E HOOKER ST
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-6032
Practice Address - Country:US
Practice Address - Phone:863-519-3436
Practice Address - Fax:863-519-6487
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL689360196OtherPROVIDER ID
FL689360198OtherPROVIDER ID