Healthcare Provider Details

I. General information

NPI: 1255817391
Provider Name (Legal Business Name): HILL MEDICAL MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12555 ORANGE DR STE 104
DAVIE FL
33330-4304
US

IV. Provider business mailing address

12555 ORANGE DR STE 104
DAVIE FL
33330-4304
US

V. Phone/Fax

Practice location:
  • Phone: 954-638-5102
  • Fax: 954-239-3902
Mailing address:
  • Phone: 954-638-5102
  • Fax: 954-239-3902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: LYDIA E ARVELO
Title or Position: MANAGER
Credential:
Phone: 954-638-5102