Provider Demographics
NPI:1477001717
Name:HOBBS, MICHAEL JARED (PA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JARED
Last Name:HOBBS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4995 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-7079
Mailing Address - Country:US
Mailing Address - Phone:772-465-3225
Mailing Address - Fax:772-465-7687
Practice Address - Street 1:4995 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-7079
Practice Address - Country:US
Practice Address - Phone:772-465-3225
Practice Address - Fax:772-465-7687
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9109795363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical