MEDICARE: ERICA L. HILL, PH.D., P.A.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	103TF0000X	Family Psychologist
3	103TH0004X	Health Psychologist
4	103TC0700X	Clinical Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	54811	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1760619977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERICA L. HILL, PH.D., P.A.

Provider Business Mailing Address
First Line	:	1975 E SUNRISE BLVD
Second Line	:	SUITE 534
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1433
Country	:	US
Telephone Number	:
Fax Number	:	954-760-4358

Provider Business Practice Location Address
First Line	:	1975 E SUNRISE BLVD
Second Line	:	SUITE 534
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1433
Country	:	US
Telephone Number	:	954-232-6882
Fax Number	:	954-760-4358

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ERICA L HILL
Credential	:	PH.D.
Telephone Number	:	954-232-6882

Provider Enumeration Date	:	06/15/2009
Last Update Date	:	06/15/2009

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