Provider Demographics
NPI:1619408200
Name:HODSON & MEISTER, P.A.
Entity Type:Organization
Organization Name:HODSON & MEISTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HODSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-725-8907
Mailing Address - Street 1:3000 ISLAND BLVD
Mailing Address - Street 2:APT 1402
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4923
Mailing Address - Country:US
Mailing Address - Phone:305-725-8907
Mailing Address - Fax:
Practice Address - Street 1:18333 NE 19TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-5031
Practice Address - Country:US
Practice Address - Phone:305-725-8907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21710261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental