=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609456359
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EDWARD JOHN HILT MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2021
-----------------------------------------------------
Last Update Date | 10/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 630 PASADENA AVE S
-----------------------------------------------------
City | ST PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33707-2128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-360-1784
-----------------------------------------------------
Fax | 727-360-1823
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2995 DREW ST FL 2
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33759-3012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-315-6974
-----------------------------------------------------
Fax | 813-635-2613
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 163048
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------