Provider Demographics
NPI:1740966787
Name:HILL, LATRICE MONIQUE
Entity type:Individual
Prefix:DR
First Name:LATRICE
Middle Name:MONIQUE
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 NW 84TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4336
Mailing Address - Country:US
Mailing Address - Phone:305-726-5075
Mailing Address - Fax:
Practice Address - Street 1:1290 NW 84TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4336
Practice Address - Country:US
Practice Address - Phone:305-726-5075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
335E00000X
FL272260612246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No335E00000XSuppliersProsthetic/Orthotic Supplier