Individual
ILZE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
PO BOX 1268, NEW SMYRNA BEACH, FL 32170-1268
(386) 259-8803
(386) 213-9981
Mailing address
PO BOX 1268, NEW SMYRNA BEACH, FL 32170-1268
(386) 259-8803
(386) 213-9981
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME124762
FL
208VP0000X
Pain Medicine Physician
ME124762
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112624200
—
FL
Enumeration date
03/04/2016
Last updated
07/12/2024
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