Basic Information
| Provider Information | |||||||||
| NPI: | 1598737793 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HITE | ||||||||
| FirstName: | DOROTHY | ||||||||
| MiddleName: | PETERS | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MPAS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 151 SOUTHHALL LN | ||||||||
| Address2: | STE 300 | ||||||||
| City: | MAITLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327517172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078752080 | ||||||||
| FaxNumber: | 4076503455 | ||||||||
| Practice Location | |||||||||
| Address1: | 1503 BUENOS AIRES BLVD | ||||||||
| Address2: | |||||||||
| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321596821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527532812 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2006 | ||||||||
| LastUpdateDate: | 04/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA9102050 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 592660405 | 01 | FL | GROUP TAX ID # | OTHER | 10D0272724 | 01 | FL | CLIA # | OTHER | CG7408 | 01 | FL | RAILROAD M/C GROUP # | OTHER | K1373 | 01 | FL | MEDICARE GROUP # | OTHER | 970028747 | 01 | FL | RAILROAD M/C PROVIDER # | OTHER |