Healthcare Provider Details

I. General information

NPI: 1780503110
Provider Name (Legal Business Name): CEDAR GROVE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 E BRANDON BLVD # 2085
BRANDON FL
33511-5509
US

IV. Provider business mailing address

1032 E BRANDON BLVD # 2085
BRANDON FL
33511-5509
US

V. Phone/Fax

Practice location:
  • Phone: 918-774-5470
  • Fax: 656-621-0623
Mailing address:
  • Phone: 918-774-5470
  • Fax: 656-621-0623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA J HILL
Title or Position: OWNER
Credential: NP
Phone: 918-774-5470