MEDICARE: HILAREE F KASPER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA9103464	FL

General Provider Information

NPI Number	:	1629048764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILAREE F KASPER PA-C

Provider Business Mailing Address
First Line	:	500 WINDERLEY PL
Second Line	:	SUITE 115
City	:	MAITLAND
State	:	FL
Zip	:	32751-7247
Country	:	US
Telephone Number	:	407-875-0555
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 CELEBRATION PL STE 200
Second Line	:
City	:	CELEBRATION
State	:	FL
Zip	:	34747-5432
Country	:	US
Telephone Number	:	407-303-4673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	02/25/2009

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