Provider Demographics
NPI:1609943232
Name:HOBBS, SIDNEY MARK (RPH)
Entity Type:Individual
Prefix:MR
First Name:SIDNEY
Middle Name:MARK
Last Name:HOBBS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N BANANA RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-2546
Mailing Address - Country:US
Mailing Address - Phone:321-452-5001
Mailing Address - Fax:321-452-6716
Practice Address - Street 1:119 N BANANA RIVER DR
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-2546
Practice Address - Country:US
Practice Address - Phone:321-452-5001
Practice Address - Fax:321-452-6716
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 19147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist