Provider Demographics
NPI:1710223201
Name:OMNI MEDICAL CONSULTANTS LLC
Entity Type:Organization
Organization Name:OMNI MEDICAL CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-779-3033
Mailing Address - Street 1:301 YAMATO RD
Mailing Address - Street 2:SUITE 1240
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4917
Mailing Address - Country:US
Mailing Address - Phone:561-779-3033
Mailing Address - Fax:
Practice Address - Street 1:301 YAMATO RD
Practice Address - Street 2:SUITE 1240
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4917
Practice Address - Country:US
Practice Address - Phone:561-779-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization