Provider Demographics
NPI:1265888168
Name:HILL ORTHOPEDIC CENTER LLC
Entity type:Organization
Organization Name:HILL ORTHOPEDIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-447-7001
Mailing Address - Street 1:108 PARK PLACE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-6857
Mailing Address - Country:US
Mailing Address - Phone:407-447-7001
Mailing Address - Fax:407-447-7006
Practice Address - Street 1:108 PARK PLACE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-6857
Practice Address - Country:US
Practice Address - Phone:407-447-7001
Practice Address - Fax:407-447-7006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75569174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty