Provider Demographics
NPI:1275795361
Name:HUBERT, JAMES G (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:HUBERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3820 NORTHDALE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1893
Mailing Address - Country:US
Mailing Address - Phone:800-991-6117
Mailing Address - Fax:888-812-8191
Practice Address - Street 1:8029 COOPER CREEK BLVD STE 104
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-3003
Practice Address - Country:US
Practice Address - Phone:800-991-6117
Practice Address - Fax:888-812-8191
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9568202K00000X, 207QH0002X, 2086S0129X
OH3400452086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0848104Medicaid
OH107932000OtherCAQH
OHH438290Medicare PIN
OH107932000OtherCAQH