Provider Demographics
NPI:1124842364
Name:HSA FLORIDA PHYSICIAN GROUP INC
Entity type:Organization
Organization Name:HSA FLORIDA PHYSICIAN GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-666-0602
Mailing Address - Street 1:2001 W 68TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1801
Mailing Address - Country:US
Mailing Address - Phone:305-820-6657
Mailing Address - Fax:
Practice Address - Street 1:7150 W 20TH AVE STE 615
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5511
Practice Address - Country:US
Practice Address - Phone:305-820-6657
Practice Address - Fax:305-820-6658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty