Healthcare Provider Details

I. General information

NPI: 1285165290
Provider Name (Legal Business Name): HILL ORTHOPEDIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 HUNTERS PARK LN STE.117
ORLANDO FL
32837-7615
US

IV. Provider business mailing address

4125 HUNTERS PARK LN STE.117
ORLANDO FL
32837-7615
US

V. Phone/Fax

Practice location:
  • Phone: 407-447-7001
  • Fax: 407-447-7006
Mailing address:
  • Phone: 407-447-7001
  • Fax: 407-447-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9110174
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9110174
License Number StateFL

VIII. Authorized Official

Name: NATHAN B HILL JR.
Title or Position: OWNER
Credential: M.D
Phone: 407-447-7001