Healthcare Provider Details

I. General information

NPI: 1043285018
Provider Name (Legal Business Name): HILL NUTRITION ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 SE FEDERAL HIGHWAY SUITE #330
STUART FL
34994-4590
US

IV. Provider business mailing address

2400 SE FEDERAL HIGHWAY SUITE #330
STUART FL
34994-4590
US

V. Phone/Fax

Practice location:
  • Phone: 772-220-8058
  • Fax: 772-220-8067
Mailing address:
  • Phone: 772-220-8058
  • Fax: 772-220-8067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. WILLIAM A HILL
Title or Position: VP
Credential: MS,RD,LD/N
Phone: 772-220-8058