Provider Demographics
NPI:1235800442
Name:HOOPER, JAMES CAMERON HARDING (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CAMERON HARDING
Last Name:HOOPER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 W BEARSS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1120
Mailing Address - Country:US
Mailing Address - Phone:813-600-0231
Mailing Address - Fax:
Practice Address - Street 1:3345 S DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-7817
Practice Address - Country:US
Practice Address - Phone:813-234-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9115033363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant