Hicks, Mary Ann

Hicks, Mary Ann is an individual health care provider with primary practice located at 10141 Big Bend Rd Ste 103 , Riverview FL 33578-7421. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Hicks, Mary Ann can be contacted via phone (813) 302-8740.

Contact Information

Primary practice address
10141 Big Bend Rd Ste 103 Riverview FL 33578-7421
Fax: (813) 605-6060
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME88392 Florida

Profile Details

NPI number 1669451050
LBN Legal business name Hicks, Mary Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated Jun 13th, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669451050 NPPES
Florida MEDICAID 268120000

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