Healthcare Provider Details

I. General information

NPI: 1942999818
Provider Name (Legal Business Name): HILDA G TOLENTINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5449 S SEMORAN BLVD STE 216C
ORLANDO FL
32822-1779
US

IV. Provider business mailing address

5449 S SEMORAN BLVD STE 216C
ORLANDO FL
32822-1779
US

V. Phone/Fax

Practice location:
  • Phone: 407-734-3338
  • Fax:
Mailing address:
  • Phone: 407-734-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW18666
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: