=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700066180
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HILTON BECKER MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/14/2007
-----------------------------------------------------
Last Update Date | 11/14/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 670 GLADES RD SUITE 220
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33431-6461
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-394-6656
-----------------------------------------------------
Fax | 561-394-4022
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 670 GLADES RD SUITE 220
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33431-6461
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-394-6656
-----------------------------------------------------
Fax | 561-394-4022
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. HILTON BECKER
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 561-394-6656
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | ME36162
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------