Healthcare Provider Details

I. General information

NPI: 1548738008
Provider Name (Legal Business Name): TERESITA JUAN HINTERBERGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 N MILITARY TRL
RIVIERA BEACH FL
33410-7417
US

IV. Provider business mailing address

1825 COPLEY PL
DELRAY BEACH FL
33445-6717
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-1500
  • Fax:
Mailing address:
  • Phone: 561-706-3904
  • Fax: 561-498-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License NumberRN1900252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: