Provider Demographics
NPI:1285774000
Name:HILL, SHANTE' CAMILLE (ATC, LAT)
Entity type:Individual
Prefix:
First Name:SHANTE'
Middle Name:CAMILLE
Last Name:HILL
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7812 RICHWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:407-539-4964
Mailing Address - Fax:
Practice Address - Street 1:3451 TECHNOLOGICAL AVENUE
Practice Address - Street 2:SUITE 1
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1476
Practice Address - Country:US
Practice Address - Phone:407-681-2520
Practice Address - Fax:407-681-2521
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL # 12502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer