Provider Demographics
NPI:1487170114
Name:HOOVER, PAOLA M (APRN)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:M
Last Name:HOOVER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 SW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2968
Mailing Address - Country:US
Mailing Address - Phone:305-266-2424
Mailing Address - Fax:305-692-0728
Practice Address - Street 1:2575 SW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2968
Practice Address - Country:US
Practice Address - Phone:305-266-2424
Practice Address - Fax:305-692-0728
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9264921363LF0000X
FL9264921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9264921OtherPA