Bonnie B. Hudak, MD

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

ME69794 Issued in FL

Practice address

807 Childrens Way
Jacksonville, FL 32207-8426

Phone

(904) 390-3788

Fax

(904) 390-3429

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1386658615
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1457467375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 CHILDRENS WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078426",
            "telephone_number": "904-390-3788",
            "fax_number": "904-390-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "BONNIE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME69794",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "ME69794",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "ME69794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000693514A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379239100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Huber Matos MD PA
• Kristen Marie Huber, APRN
• Danielle Huckaba, MS CCC-SLP
• Nancy Elaine Hucker, LMHC
• Margaret Louise Hucks, REGISTERED DIETITIAN
• Mark Lawrence Hudak, M.D.
• Amy Elizabeth Huddleston McDaniel, O.D.
• Kathryn Welch Huddleston, M.D.
• Hudson Valley Radiologists, PC
• Christine Hudson, LMHC

• Pediatric Pulmonology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Pulmonology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.