1811084783 NPI number — F.A. HAUBER ,M.D., P.A.

Table of content: (NPI 1811084783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811084783 NPI number — F.A. HAUBER ,M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
F.A. HAUBER ,M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PASCO EYE INSTITUTE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811084783
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5347 MAIN STREET
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
NEW PORT RICHEY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34652-2506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-847-4448
Provider Business Mailing Address Fax Number:
727-845-1572

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5347 MAIN STREET
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
NEW PORT RICHEY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34652-2506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-847-4448
Provider Business Practice Location Address Fax Number:
727-845-1572
Provider Enumeration Date:
10/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAHER
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
J
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
727-847-4448

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: ME0025741 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0897190001 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 056786800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".