Healthcare Provider Details

I. General information

NPI: 1740966787
Provider Name (Legal Business Name): DR. LATRICE MONIQUE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 NW 84TH TER
MIAMI FL
33147-4336
US

IV. Provider business mailing address

1290 NW 84TH TER
MIAMI FL
33147-4336
US

V. Phone/Fax

Practice location:
  • Phone: 305-726-5075
  • Fax:
Mailing address:
  • Phone: 305-726-5075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number272260612
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: