MEDICARE: KEILA HOOVER M.D.

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	207Q00000X	Family Medicine Physician	ME 94105	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME 94105	OTHER	FL	LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417909375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEILA HOOVER M.D.

Provider Business Mailing Address
First Line	:	7371 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-1402
Country	:	US
Telephone Number	:	305-443-3001
Fax Number	:

Provider Business Practice Location Address
First Line	:	7371 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-1402
Country	:	US
Telephone Number	:	305-265-4441
Fax Number	:	305-265-4844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	03/07/2023

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