MEDICARE: HILL ORTHOPEDIC CENTER LLC

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	363AS0400X	Surgical Physician Assistant	PA9110174	FL
2	363AM0700X	Medical Physician Assistant	PA9110174	FL

General Provider Information

NPI Number	:	1285165290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILL ORTHOPEDIC CENTER LLC

Provider Business Mailing Address
First Line	:	4125 HUNTERS PARK LN
Second Line	:	STE.117
City	:	ORLANDO
State	:	FL
Zip	:	32837-7615
Country	:	US
Telephone Number	:	407-447-7001
Fax Number	:	407-447-7006

Provider Business Practice Location Address
First Line	:	4125 HUNTERS PARK LN
Second Line	:	STE.117
City	:	ORLANDO
State	:	FL
Zip	:	32837-7615
Country	:	US
Telephone Number	:	407-447-7001
Fax Number	:	407-447-7006

Authorized Official
Title or Position	:	OWNER
Name	:	NATHAN B HILL JR.
Credential	:	M.D
Telephone Number	:	407-447-7001

Provider Enumeration Date	:	03/22/2017
Last Update Date	:	03/22/2017

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Directions to “HILL ORTHOPEDIC CENTER LLC ” Practice Location

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