Hackman-Kerbyson, Eleonora
Hackman-Kerbyson, Eleonora is an individual health care provider with primary practice located at 2450 Tamiami Trl Ste A, Port Charlotte FL 33952-3922. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Hackman-Kerbyson, Eleonora can be contacted via phone (941) 624-2704.Contact Information
Primary practice address
2450 Tamiami Trl Ste A
Port Charlotte FL 33952-3922
Phone: (941) 624-2704
Fax: (941) 627-6066
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 2003014738 | Missouri |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036-110911 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME104987 | Florida |
Profile Details
| NPI number | 1720020852 |
|---|---|
| LBN Legal business name | Hackman-Kerbyson, Eleonora |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Feb 20th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720020852 | NPPES |
| Missouri | Other | 426403 | HEALTHLINK |
| Missouri | Other | 124884 | HEALTHLINK |
| Missouri | MEDICAID | 208440818 | HEALTHLINK |
| Missouri | Other | 947071631 | HEALTHLINK |
| Missouri | Other | P00145175 | HEALTHLINK |
| Missouri | MEDICAID | 036110911 | HEALTHLINK |
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