Healthcare Provider Details

I. General information

NPI: 1699778910
Provider Name (Legal Business Name): CHRISTOPHER HILL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LONGWOOD AVENUE
ROCKLEDGE FL
32955-0000
US

IV. Provider business mailing address

2254 HIGHWAY A1A
INDIAN HARBOUR BEACH FL
32937-4922
US

V. Phone/Fax

Practice location:
  • Phone: 800-476-8646
  • Fax: 919-382-3210
Mailing address:
  • Phone: 213-777-2273
  • Fax: 213-779-7425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS8088
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: