MEDICARE: JOHN BANCROFT HYLTON M.D,P.A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	ME0060538	FL
2	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225378516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN BANCROFT HYLTON M.D,P.A

Provider Business Mailing Address
First Line	:	12323 SW 55TH ST
Second Line	:	SUITE 1003
City	:	COOPER CITY
State	:	FL
Zip	:	33330-3312
Country	:	US
Telephone Number	:	954-252-0083
Fax Number	:	954-252-0207

Provider Business Practice Location Address
First Line	:	12323 SW 55TH ST
Second Line	:	SUITE 1003
City	:	COOPER CITY
State	:	FL
Zip	:	33330-3312
Country	:	US
Telephone Number	:	954-252-0083
Fax Number	:	954-252-0207

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN BANCROFT HYLTON
Credential	:	M.D.
Telephone Number	:	954-252-0083

Provider Enumeration Date	:	02/22/2013
Last Update Date	:	05/21/2024

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