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General NPI Number Information
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NPI Number | 1215396395
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Entity Type | Individual
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Provider Name | VICTOR HILLAERT CRNP
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Gender | Male
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 10780 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90025-4749
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Country | US
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Telephone | 310-850-8657
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Fax |
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Provider Business Mailing Address
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Address Line | 30102 CHEVAL ST
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City | MOUNT DORA
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State | FL
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Zip | 32757-7817
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Country | US
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Telephone | 443-880-8096
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R199804
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 9447760
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LG-0001152
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95030939
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R199804
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License Number State | MD
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