Provider Demographics
NPI:1639790348
Name:HOSHOR, AVERY (PA)
Entity Type:Individual
Prefix:MS
First Name:AVERY
Middle Name:
Last Name:HOSHOR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AVER7
Other - Middle Name:NICOLE
Other - Last Name:HOSHOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1850 SE 18TH AVE APT 1108
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8255
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:47 SW 17TH ST STE A
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8104
Practice Address - Country:US
Practice Address - Phone:352-512-9996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical