Provider Demographics
NPI:1770306409
Name:HUGHES, CAROLINE KAYLA (PA-C)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:KAYLA
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3776 COUNTY ROAD 315A
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-8816
Mailing Address - Country:US
Mailing Address - Phone:717-817-5680
Mailing Address - Fax:
Practice Address - Street 1:6817 SOUTHPOINT PKWY STE 2502
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8200
Practice Address - Country:US
Practice Address - Phone:904-955-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9119256207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology