Provider Demographics
NPI:1891016531
Name:JOHN W HOOVER III MD PA
Entity Type:Organization
Organization Name:JOHN W HOOVER III MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WOODWARD
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:305-979-3994
Mailing Address - Street 1:7375 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1402
Mailing Address - Country:US
Mailing Address - Phone:305-979-3994
Mailing Address - Fax:
Practice Address - Street 1:7375 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1402
Practice Address - Country:US
Practice Address - Phone:305-979-3994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93934207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty