Provider Demographics
NPI:1093998908
Name:PAUL HILBERT D P M P A
Entity Type:Organization
Organization Name:PAUL HILBERT D P M P A
Other - Org Name:COASTAL PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:850-936-5226
Mailing Address - Street 1:8880 NAVARRE PKWY.
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566
Mailing Address - Country:US
Mailing Address - Phone:850-936-5226
Mailing Address - Fax:850-936-5254
Practice Address - Street 1:8880 NAVARRE PKWY.
Practice Address - Street 2:SUITE 106
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566
Practice Address - Country:US
Practice Address - Phone:850-936-5226
Practice Address - Fax:850-936-5254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2256332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390068100Medicaid
FL0664010001Medicare NSC
FLU39900Medicare UPIN