Healthcare Provider Details

I. General information

NPI: 1053164731
Provider Name (Legal Business Name): KARL HILAIRE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 NW 87TH ST
EL PORTAL FL
33150-2416
US

IV. Provider business mailing address

96 NW 87TH ST
EL PORTAL FL
33150-2416
US

V. Phone/Fax

Practice location:
  • Phone: 786-416-2753
  • Fax:
Mailing address:
  • Phone: 786-416-2753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9567284
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number81724801
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number81724801
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: