Provider Demographics
NPI:1265514459
Name:HILL, NATHAN BERNARD JR (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:BERNARD
Last Name:HILL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4125 HUNTERS PARK LN
Mailing Address - Street 2:SUITE 117
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7669
Mailing Address - Country:US
Mailing Address - Phone:407-447-7001
Mailing Address - Fax:407-447-7006
Practice Address - Street 1:4125 HUNTERS PARK LN
Practice Address - Street 2:SUITE 117
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7669
Practice Address - Country:US
Practice Address - Phone:407-447-7001
Practice Address - Fax:407-447-7006
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME75569207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL202912OtherWELLCARE
FL254464400Medicaid
FL6719680001OtherMEDICARE DME LICENSE
FL218613OtherAMERIGROUP
FL3496273OtherAETNA
FL47471ZOtherBCBS
FL6071543600OtherACS
FLK5099OtherMEDICARE PTAN
FL47471ZOtherBCBS