Provider Demographics
NPI:1700885753
Name:HUGHES, TEENA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:TEENA
Middle Name:LYNN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4444 E FLETCHER AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4937
Mailing Address - Country:US
Mailing Address - Phone:813-903-0060
Mailing Address - Fax:813-903-1773
Practice Address - Street 1:4444 E FLETCHER AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4937
Practice Address - Country:US
Practice Address - Phone:813-903-0060
Practice Address - Fax:813-903-1773
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0063388208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379178500Medicaid
FL379178500Medicaid