Provider Demographics
NPI:1053781948
Name:HUGHES, EDWARD A (PA)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:A
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:5147 N 9TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8770
Practice Address - Country:US
Practice Address - Phone:850-494-9000
Practice Address - Fax:850-416-1912
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2021-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9108983363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant