Provider Demographics
NPI:1932239464
Name:HILTON, JEFFREY C (OD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:C
Last Name:HILTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 NE 95TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2706
Mailing Address - Country:US
Mailing Address - Phone:305-754-1868
Mailing Address - Fax:
Practice Address - Street 1:800 E BROWARD BLVD
Practice Address - Street 2:#106
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2008
Practice Address - Country:US
Practice Address - Phone:954-524-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2054152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620126100Medicaid
FL620126100Medicaid
FLT84213Medicare UPIN