Provider Demographics
NPI: | 1649755752 |
---|---|
Name: | HILL, ROBYN L (APRN) |
Entity Type: | Individual |
Prefix: | |
First Name: | ROBYN |
Middle Name: | L |
Last Name: | HILL |
Suffix: | |
Gender: | F |
Credentials: | APRN |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2900 CORPORATE WAY |
Mailing Address - Street 2: | DOOR D |
Mailing Address - City: | MIRAMAR |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33025-3925 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 954-276-5685 |
Mailing Address - Fax: | 954-985-7074 |
Practice Address - Street 1: | 1750 E HALLANDALE BEACH BLVD |
Practice Address - Street 2: | |
Practice Address - City: | HALLANDALE BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33009-4611 |
Practice Address - Country: | US |
Practice Address - Phone: | 954-265-4325 |
Practice Address - Fax: | 954-276-0765 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2018-09-25 |
Last Update Date: | 2022-03-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | 3264662 | 363LF0000X |
FL | APRN3264662 | 363L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 102009500 | Medicaid |