Provider Demographics
NPI:1770151169
Name:MACDONALD, HILLARY (PA-C)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 SE 6TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5306
Mailing Address - Country:US
Mailing Address - Phone:561-440-8020
Mailing Address - Fax:561-440-8222
Practice Address - Street 1:550 SE 6TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5306
Practice Address - Country:US
Practice Address - Phone:561-440-8020
Practice Address - Fax:561-440-8222
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9114446363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant