Healthcare Provider Details

I. General information

NPI: 1073639035
Provider Name (Legal Business Name): ANA GAEL HITCHMAN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 NW 18TH TER APT 1109
MIAMI FL
33136-1136
US

IV. Provider business mailing address

750 NW 18TH TER APT 1109
MIAMI FL
33136-1136
US

V. Phone/Fax

Practice location:
  • Phone: 786-356-8770
  • Fax:
Mailing address:
  • Phone: 786-356-8770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN5168342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: