Provider Demographics
NPI:1730400045
Name:HINA, MATTHEW JASON (CRNA)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JASON
Last Name:HINA
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BANYAN PASS LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-8785
Mailing Address - Country:US
Mailing Address - Phone:352-572-7729
Mailing Address - Fax:
Practice Address - Street 1:1431 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6500
Practice Address - Country:US
Practice Address - Phone:352-572-7729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9232034367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002473200Medicaid
FLG00E1OtherBLUE CROSS BLUE SHIELD
FLDK191VMedicare PIN