Provider Demographics
NPI:1538456389
Name:HOGLUND, PATRICIA YVONNE (BC-HIS,ACA)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:YVONNE
Last Name:HOGLUND
Suffix:
Gender:F
Credentials:BC-HIS,ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 8TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7455
Mailing Address - Country:US
Mailing Address - Phone:239-498-7142
Mailing Address - Fax:239-498-9631
Practice Address - Street 1:15 8TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7455
Practice Address - Country:US
Practice Address - Phone:239-498-7142
Practice Address - Fax:239-498-9631
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2611332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment