Provider Demographics
NPI:1477860021
Name:HILL, JENNIFER LUANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LUANNE
Last Name:HILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S COURT AVE
Mailing Address - Street 2:UNIT 2512
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3205
Mailing Address - Country:US
Mailing Address - Phone:734-709-5459
Mailing Address - Fax:
Practice Address - Street 1:104 MARCIA DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2913
Practice Address - Country:US
Practice Address - Phone:407-862-7234
Practice Address - Fax:407-862-2748
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4612152W00000X, 152WC0802X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics