Provider Demographics
NPI:1073620290
Name:KENT-HILGENFELDT, LAURA M (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:KENT-HILGENFELDT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2465
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-2465
Mailing Address - Country:US
Mailing Address - Phone:352-622-8152
Mailing Address - Fax:352-622-7522
Practice Address - Street 1:1541 SW 1ST AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-622-8152
Practice Address - Fax:352-622-7522
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9101547363AS0400X
FLPA9101547363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical