Provider Demographics
NPI:1902914641
Name:HUBMANN, MONICA (ARNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:HUBMANN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 CENTERVILLE RD STE 504
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4640
Mailing Address - Country:US
Mailing Address - Phone:850-431-5001
Mailing Address - Fax:850-431-6101
Practice Address - Street 1:1401 CENTERVILLE RD STE 504
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4640
Practice Address - Country:US
Practice Address - Phone:850-431-5001
Practice Address - Fax:850-431-6101
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1898862363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY033POtherBLUE CROSS PROVIDER
FL591917016OtherCOMMERCIAL PROVIDER NUMBE
FLP89868Medicare UPIN
FL591917016OtherCOMMERCIAL PROVIDER NUMBE