Provider Demographics
NPI:1609917566
Name:ELEANINE HARDY-HUNTER MD, PA
Entity type:Organization
Organization Name:ELEANINE HARDY-HUNTER MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELEANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-872-4401
Mailing Address - Street 1:PO BOX 46386
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33646-0104
Mailing Address - Country:US
Mailing Address - Phone:813-872-4401
Mailing Address - Fax:813-872-4814
Practice Address - Street 1:2901 ST. ISABEL STREET
Practice Address - Street 2:SUITE A3
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6388
Practice Address - Country:US
Practice Address - Phone:813-872-4401
Practice Address - Fax:813-872-4814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90667207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270423400Medicaid
FLI26409Medicare UPIN