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Individual

MODE M HILAIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
4982 SW 127TH AVE, MIRAMAR, FL 33027-5815
(786) 704-1557
Mailing address
4982 SW 127TH AVE, MIRAMAR, FL 33027-5815
(786) 704-1557

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9300927
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11009072
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H4606553658010
DL
FL
Enumeration date
01/17/2018
Last updated
09/11/2020
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