Provider Demographics
NPI:1306232392
Name:PARK, HYOSUN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:HYOSUN
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, STE. 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-6984
Mailing Address - Country:US
Mailing Address - Phone:703-914-8000
Mailing Address - Fax:
Practice Address - Street 1:1910 SW 18TH CT STE 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7857
Practice Address - Country:US
Practice Address - Phone:352-629-7011
Practice Address - Fax:866-592-7773
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9324866363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner