Healthcare Provider Details

I. General information

NPI: 1548725864
Provider Name (Legal Business Name): ANGELA D HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2019
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AEROSPACE BLVD
DAYTONA BEACH FL
32114-3910
US

IV. Provider business mailing address

1 AEROSPACE BLVD
DAYTONA BEACH FL
32114-3910
US

V. Phone/Fax

Practice location:
  • Phone: 386-226-7917
  • Fax: 386-226-6082
Mailing address:
  • Phone: 386-226-7917
  • Fax: 386-226-6082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number9379217
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11037091
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: