Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Gordon Hathcock, PA

Individual provider Physician Assistant · NPI 1992375554

Samuel Gordon Hathcock, PA is a Physician Assistant in Celebration, Florida. Qualified in 2021, 5 years ago. Practices with Florida Hospital Medical Group Inc, a 1,715-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida and Virginia.

Years since qualifying
5
Licensed in
FL, VA
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

410 Celebration Pl Ste 300
Celebration, FL 34747-5434
Phone: (407) 894-4474
Fax: (407) 894-7032
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4645 Nw 8th Ave, Gainesville, FL 32605-4687 — (352) 375-1212

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9116218 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 0110-008149 (VA)

Record details

NPI number1992375554
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 28, 2021
Last updated in NPPESJanuary 16, 2024
Certification dateJanuary 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Florida Hospital Medical Group Inc — 1715 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Celebration