Healthcare Provider Details

I. General information

NPI: 1124207931
Provider Name (Legal Business Name): EMILIYA S HILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 10/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3822 BROADWAY SUITES A-C
FORT MYERS FL
33901-8148
US

IV. Provider business mailing address

3822 BROADWAY SUITES A-C
FORT MYERS FL
33901-8148
US

V. Phone/Fax

Practice location:
  • Phone: 239-274-3004
  • Fax: 239-274-6007
Mailing address:
  • Phone: 239-274-3004
  • Fax: 239-274-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRL10244
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberME105043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: