Provider Demographics
NPI:1558320721
Name:HILL, DOROTHY JEANNETTE (DO)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:JEANNETTE
Last Name:HILL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 18TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6481
Mailing Address - Country:US
Mailing Address - Phone:772-925-8200
Mailing Address - Fax:772-925-8199
Practice Address - Street 1:981 37TH PL
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6541
Practice Address - Country:US
Practice Address - Phone:772-257-5785
Practice Address - Fax:772-257-5325
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8603208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71208OtherBCBS PROVIDER #
FL268211700Medicaid
FL71208OtherBCBS PROVIDER #