Healthcare Provider Details

I. General information

NPI: 1679404693
Provider Name (Legal Business Name): FELICIA HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 A1A S
ST AUGUSTINE FL
32080-6591
US

IV. Provider business mailing address

116 DOVIL ST
INTERLACHEN FL
32148-6307
US

V. Phone/Fax

Practice location:
  • Phone: 352-792-9279
  • Fax:
Mailing address:
  • Phone: 352-792-9279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number85281
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: