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1801 Se Hillmoor Drive Suite C-106 Port St. Lucie FL 34952-7551 | |
| (772) 249-0636 | |
| (772) 237-3114 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1801 Se Hillmoor Drive, Port St. Lucie, Florida |
| Authorized Official Name and Position | Dionne Layne Hinds (OWNER) |
| Authorized Official Contact | 7722490636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1801 Se Hillmoor Drive Suite C-106 Port St. Lucie FL 34952-7551 Ph: (772) 249-0636 | 1801 Se Hillmoor Drive Suite C-106 Port St. Lucie FL 34952-7551 Ph: (772) 249-0636 |
| NPI Number | 1851729693 |
|---|---|
| Provider Enumeration Date | 10/14/2013 |
| Last Update Date | 11/15/2024 |
| Medicare PECOS PAC ID | 6305072455 |
|---|---|
| Medicare Enrollment ID | O20131119000750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851729693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME106391 (Florida) | Primary |
| Provider Name | Dionne L Hinds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154593184 PECOS PAC ID: 8820123060 Enrollment ID: I20100312000982 |
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