Healthcare Provider Details

I. General information

NPI: 1770696445
Provider Name (Legal Business Name): GORDON E HILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 N FEDERAL HWY
FT LAUDERDALE FL
33308-4603
US

IV. Provider business mailing address

4725 N FEDERAL HWY
FT LAUDERDALE FL
33308-4603
US

V. Phone/Fax

Practice location:
  • Phone: 954-958-4800
  • Fax: 954-958-4899
Mailing address:
  • Phone: 954-958-4800
  • Fax: 954-958-4899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME8679
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: