Provider Demographics
NPI:1801506373
Name:HILL, TAKIA LERONA
Entity type:Individual
Prefix:
First Name:TAKIA
Middle Name:LERONA
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 NE 1ST AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4669
Mailing Address - Country:US
Mailing Address - Phone:800-798-8015
Mailing Address - Fax:
Practice Address - Street 1:21655 SW 104TH CT APT 102
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1049
Practice Address - Country:US
Practice Address - Phone:800-798-8015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide