Provider Demographics
NPI:1922871458
Name:HUNT, PAUL ANTHONY KEITH
Entity Type:Individual
Prefix:
First Name:PAUL ANTHONY
Middle Name:KEITH
Last Name:HUNT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7860 NW 54TH ST
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5055
Mailing Address - Country:US
Mailing Address - Phone:954-548-6623
Mailing Address - Fax:
Practice Address - Street 1:7860 NW 54TH ST
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5055
Practice Address - Country:US
Practice Address - Phone:954-548-6623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-304857106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician