Provider Demographics
NPI:1417323304
Name:MCHUGH, AIXA
Entity Type:Individual
Prefix:MS
First Name:AIXA
Middle Name:
Last Name:MCHUGH
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 1:881 103RD AVE N STE 5
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-3200
Mailing Address - Country:US
Mailing Address - Phone:239-597-8805
Mailing Address - Fax:239-597-6558
Practice Address - Street 1:881 103RD AVE N STE 5
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-3200
Practice Address - Country:US
Practice Address - Phone:239-597-8805
Practice Address - Fax:239-597-6558
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1155332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL684490100Medicaid
FL684490100Medicaid