MEDICARE: JOAN LILIETH HILL REGISTERED NURSE

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	163WH0200X	Home Health Registered Nurse	9497624	FL
2	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1821826264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN LILIETH HILL REGISTERED NURSE

Provider Business Mailing Address
First Line	:	1609 PINE LAKE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-6324
Country	:	US
Telephone Number	:	140-740-9616
Fax Number	:	407-656-8209

Provider Business Practice Location Address
First Line	:	1609 PINE LAKE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-6324
Country	:	US
Telephone Number	:	140-740-9616
Fax Number	:	407-656-8209

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

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	07/25/2024

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