Provider Demographics
NPI:1548544505
Name:HILL, JAMIE T (CPED)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:T
Last Name:HILL
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3423 E SILVER SPRINGS BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6464
Mailing Address - Country:US
Mailing Address - Phone:352-390-6113
Mailing Address - Fax:352-390-6973
Practice Address - Street 1:3423 E SILVER SPRINGS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6464
Practice Address - Country:US
Practice Address - Phone:352-390-6113
Practice Address - Fax:352-390-6973
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPED192224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1548544505Medicare NSC