Provider Demographics
NPI:1134564222
Name:HINDS, JONATHAN ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ANTHONY
Last Name:HINDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9858 CLINT MOORE ROAD STE C111
Mailing Address - Street 2:#164
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1034
Mailing Address - Country:US
Mailing Address - Phone:561-289-7729
Mailing Address - Fax:916-333-3634
Practice Address - Street 1:416 CLEMATIS ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5312
Practice Address - Country:US
Practice Address - Phone:561-289-7729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09815700207P00000X
390200000X
CAA167145207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty