Provider Demographics
NPI:1043284474
Name:HILL, HARPER AND PAREDES, PA
Entity type:Organization
Organization Name:HILL, HARPER AND PAREDES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREDES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:850-877-2126
Mailing Address - Street 1:2452 MAHAN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5377
Mailing Address - Country:US
Mailing Address - Phone:850-877-2126
Mailing Address - Fax:850-878-5190
Practice Address - Street 1:2452 MAHAN DR
Practice Address - Street 2:SUITE 101
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5377
Practice Address - Country:US
Practice Address - Phone:850-877-2126
Practice Address - Fax:850-878-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261120100Medicaid
FL99248OtherBC/BS FLORIDA
CCM7724Medicare PIN
FL261120100Medicaid