Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC 3592 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC 3592 | FL |
NPI | 1164440046 |
---|---|
Provider Name | Hilda Yadira Hite |
First Address | Orange Park, FL 32073-2625 |
Second Address | Orange Park, FL 32073-2625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 25/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
134208447 | TRICARE SOUTH REGION (01) | FL |
620764200 | (05) | FL |