Healthcare Provider Details

I. General information

NPI: 1396731519
Provider Name (Legal Business Name): JOSEPH C HILDNER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 07/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5051 SE 110TH ST
BELLEVIEW FL
34420-3115
US

IV. Provider business mailing address

5051 SE 110TH ST
BELLEVIEW FL
34420-3115
US

V. Phone/Fax

Practice location:
  • Phone: 352-245-9157
  • Fax: 352-245-3031
Mailing address:
  • Phone: 352-245-9157
  • Fax: 352-245-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH CARL HILDNER
Title or Position: OWNER
Credential: M.D.
Phone: 352-245-9157