Provider Demographics
NPI:1346253861
Name:HILAL, TALAL E (MD)
Entity Type:Individual
Prefix:
First Name:TALAL
Middle Name:E
Last Name:HILAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 LOOKOUT PLACE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-644-4014
Mailing Address - Fax:407-644-5270
Practice Address - Street 1:260 LOOKOUT PLACE
Practice Address - Street 2:SUITE 201
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-644-4014
Practice Address - Fax:407-644-5270
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39321207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067581400Medicaid
FL067581400Medicaid
FL47574Medicare ID - Type Unspecified