Healthcare Provider Details

I. General information

NPI: 1629048764
Provider Name (Legal Business Name): HILAREE F KASPER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CELEBRATION PL STE 200
CELEBRATION FL
34747-5432
US

IV. Provider business mailing address

500 WINDERLEY PL SUITE 115
MAITLAND FL
32751-7247
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-4673
  • Fax:
Mailing address:
  • Phone: 407-875-0555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9103464
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: