Healthcare Provider Details

I. General information

NPI: 1366297640
Provider Name (Legal Business Name): MR. BOAKAI E HILTON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2024
Last Update Date: 04/20/2024
Certification Date: 04/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2267 GALAHAD AVE
SPRING HILL FL
34608-4515
US

IV. Provider business mailing address

2267 GALAHAD AVE
SPRING HILL FL
34608-4515
US

V. Phone/Fax

Practice location:
  • Phone: 727-247-0817
  • Fax: 352-556-4775
Mailing address:
  • Phone: 727-247-0817
  • Fax: 352-556-4775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: