Provider Demographics
NPI:1053164731
Name:HILAIRE, KARL
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:HILAIRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 NW 87TH ST
Mailing Address - Street 2:
Mailing Address - City:EL PORTAL
Mailing Address - State:FL
Mailing Address - Zip Code:33150-2416
Mailing Address - Country:US
Mailing Address - Phone:786-416-2753
Mailing Address - Fax:
Practice Address - Street 1:96 NW 87TH ST
Practice Address - Street 2:
Practice Address - City:EL PORTAL
Practice Address - State:FL
Practice Address - Zip Code:33150-2416
Practice Address - Country:US
Practice Address - Phone:786-416-2753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9567284163W00000X
NY81724801163WG0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice