Healthcare Provider Details

I. General information

NPI: 1457547614
Provider Name (Legal Business Name): WILLIAM A. HILL MS,RD,LD/N,CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2400 SE FEDERAL HWY SUITE 330
STUART FL
34994-4591
US

IV. Provider business mailing address

2400 SE FEDERAL HWY SUITE 330
STUART FL
34994-4591
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 NumberND 268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: