Provider Demographics
NPI:1447416748
Name:HAUK, MICHAEL AARON (PA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:AARON
Last Name:HAUK
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:AARON
Other - Middle Name:
Other - Last Name:HAUK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:12902 USF MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-9416
Mailing Address - Country:US
Mailing Address - Phone:888-860-2778
Mailing Address - Fax:813-745-6511
Practice Address - Street 1:12902 USF MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9416
Practice Address - Country:US
Practice Address - Phone:888-860-2778
Practice Address - Fax:813-745-6511
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPAT9104635363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical