Healthcare Provider Details

I. General information

NPI: 1134642002
Provider Name (Legal Business Name): ADRIANE KAY HINES DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 07/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 WEKIVA SPRINGS RD
LONGWOOD FL
32779-3607
US

IV. Provider business mailing address

357 WEKIVA SPRINGS RD
LONGWOOD FL
32779-3607
US

V. Phone/Fax

Practice location:
  • Phone: 321-280-5867
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License NumberCH12259
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: