Provider Demographics
NPI:1700858206
Name:HILL, VICTORIA A (PA-C)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:A
Last Name:HILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:A
Other - Last Name:SPAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:240 N WICKHAM RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-8660
Mailing Address - Country:US
Mailing Address - Phone:321-541-1746
Mailing Address - Fax:321-676-2613
Practice Address - Street 1:240 N WICKHAM RD STE 202
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8660
Practice Address - Country:US
Practice Address - Phone:321-541-1746
Practice Address - Fax:321-676-2613
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0001-03562363AS0400X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114393400Medicaid
NC2761000Medicare ID - Type Unspecified