Provider Demographics
NPI:1396731519
Name:JOSEPH C HILDNER MD INC
Entity type:Organization
Organization Name:JOSEPH C HILDNER MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:HILDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-245-9157
Mailing Address - Street 1:5051 SE 110TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-3115
Mailing Address - Country:US
Mailing Address - Phone:352-245-9157
Mailing Address - Fax:352-245-3031
Practice Address - Street 1:5051 SE 110TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-3115
Practice Address - Country:US
Practice Address - Phone:352-245-9157
Practice Address - Fax:352-245-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL98863Medicare PIN