Healthcare Provider Details

I. General information

NPI: 1730417171
Provider Name (Legal Business Name): DR HITE AND ASSOCIATES , P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 BLANDING BLVD
ORANGE PARK FL
32073-2625
US

IV. Provider business mailing address

58 BLANDING BLVD
ORANGE PARK FL
32073-2625
US

V. Phone/Fax

Practice location:
  • Phone: 904-276-5693
  • Fax: 904-276-5594
Mailing address:
  • Phone: 904-276-5693
  • Fax: 904-276-5594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC 3592
License Number StateFL

VIII. Authorized Official

Name: HILDA YADIRA HITE
Title or Position: DIRECTOR
Credential: O.D.
Phone: 904-276-5693