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NPI Code Detail

MEDICARE: MR. DEREK JOHN HILTZ DO

MEDICARE: MR. DEREK JOHN HILTZ DO
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
1207Q00000XFamily Medicine Physician0S9333FL

Other Identifiers

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

General Provider Information

NPI Number : 1366494742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEREK JOHN HILTZ DO
Provider Business Mailing Address
First Line : 508 PASADENA AVE S STE 501
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33707-2126
Country : US
Telephone Number : 727-343-6119
Fax Number : 727-345-6286
Provider Business Practice Location Address
First Line : 1505 53RD AVE E
Second Line :
City : BRADENTON
State : FL
Zip : 34203-4249
Country : US
Telephone Number : 941-357-7950
Fax Number : 941-840-1003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 03/16/2026

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Directions to “ MR. DEREK JOHN HILTZ DO” Practice Location

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