Basic Information
Provider Information
NPI: 1376750315
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOBBS
FirstName: SEAN
MiddleName: P
NamePrefix: MR.
NameSuffix:  
Credential: M.P.T, A.T.,C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 308 REMINGTON DR
Address2:  
City: OVIEDO
State: FL
PostalCode: 327656246
CountryCode: US
TelephoneNumber: 4079712520
FaxNumber: 4079712520
Practice Location
Address1: 7400 RED BUG LAKE RD
Address2:  
City: OVIEDO
State: FL
PostalCode: 327657154
CountryCode: US
TelephoneNumber: 4079712774
FaxNumber: 4079712776
Other Information
ProviderEnumerationDate: 05/17/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT 0018150FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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