Provider Demographics
NPI:1891754073
Name:D'HOSTE, NELIA D (MD)
Entity Type:Individual
Prefix:
First Name:NELIA
Middle Name:D
Last Name:D'HOSTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-2501
Mailing Address - Country:US
Mailing Address - Phone:352-429-4101
Mailing Address - Fax:352-429-4072
Practice Address - Street 1:101 E BROAD ST
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-2501
Practice Address - Country:US
Practice Address - Phone:352-429-4101
Practice Address - Fax:352-429-4072
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0029553207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLUPINMedicare UPIN
FL60010Medicare ID - Type UnspecifiedMEDICARE