| Samuel Gordon Hathcock, PA | |
|
410 Celebration Pl Ste 300, Celebration, FL 34747-5434 | |
| (407) 894-4474 | |
| (407) 894-7032 |
| Full Name | Samuel Gordon Hathcock |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 410 Celebration Pl Ste 300, Celebration, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992375554 | NPI | - | NPPES |
| 0110-008149 | Other | VA | VIRGINIA BOARD OF MEDICINE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 0110-008149 (Virginia) | Secondary |
| 363A00000X | Physician Assistant | PA9116218 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventhealth Orlando | Orlando, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Florida Hospital Medical Group Inc | 0749186153 | 1237 |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Gordon Hathcock, PA 4645 Nw 8th Ave, Gainesville, FL 32605-4687 Ph: (352) 375-1212 | Samuel Gordon Hathcock, PA 410 Celebration Pl Ste 300, Celebration, FL 34747-5434 Ph: (407) 894-4474 |
Brylle Czimo Llaguno, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2954 Mallory Cir Ste 101, Celebration, FL 34747 Phone: 321-939-0222 Fax: 321-939-0225 | |
David Burns, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 400 Celebration Pl, Suite A350, Celebration, FL 34747 Phone: 407-303-4902 Fax: 407-303-4909 | |
Mr. John Andrich, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 410 Celebration Pl, Suite 200, Celebration, FL 34747 Phone: 407-303-4673 | |
Valentina Acosta-moreno, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 410 Celebration Place, Ste 208, Celebration, FL 34747 Phone: 877-800-0239 Fax: 407-566-2499 | |
Kimberly Camille Carter Mahamid, KIMBERLY CARTER PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 410 Celebration Pl Ste 401a, Celebration, FL 34747 Phone: 407-303-3820 | |
Michelle Anneliese De Marco, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1530 Celebration Blvd Ste 101, Celebration, FL 34747 Phone: 407-566-0404 Fax: 407-566-0411 | |
Brianna Sunitha Hereman, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 400 Celebration Pl Ste A150, Celebration, FL 34747 Phone: 407-303-3824 Fax: 407-303-3825 |