Provider Demographics
NPI:1578543088
Name:HUGHES, HERSCHEL JR (EDD)
Entity Type:Individual
Prefix:DR
First Name:HERSCHEL
Middle Name:
Last Name:HUGHES
Suffix:JR
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3361 ROUSE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2135
Mailing Address - Country:US
Mailing Address - Phone:407-277-2719
Mailing Address - Fax:407-249-0352
Practice Address - Street 1:3361 ROUSE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-2135
Practice Address - Country:US
Practice Address - Phone:407-277-2719
Practice Address - Fax:407-249-0352
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT352106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5198277OtherAETNA
FL8278000OtherMAGELLAN