Healthcare Provider Details

I. General information

NPI: 1487813655
Provider Name (Legal Business Name): CHARITY KATHERINE HILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SW 37TH AVE STE 701
CORAL GABLES FL
33133-2750
US

IV. Provider business mailing address

16 MICHAEL CT
WILMINGTON DE
19808-1138
US

V. Phone/Fax

Practice location:
  • Phone: 305-521-1368
  • Fax:
Mailing address:
  • Phone: 650-613-8430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number288780
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME139238
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberME139238
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: