Provider Demographics
NPI:1598737793
Name:HITE, DOROTHY PETERS (MPAS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:PETERS
Last Name:HITE
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN
Mailing Address - Street 2:STE 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:1503 BUENOS AIRES BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6821
Practice Address - Country:US
Practice Address - Phone:352-753-2812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102050363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL592660405OtherGROUP TAX ID #
FL10D0272724OtherCLIA #
FLCG7408OtherRAILROAD M/C GROUP #
FLK1373OtherMEDICARE GROUP #
FL970028747OtherRAILROAD M/C PROVIDER #
FLCG7408OtherRAILROAD M/C GROUP #
FLK1373OtherMEDICARE GROUP #