1225378516 NPI number — JOHN BANCROFT HYLTON M.D,P.A

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225378516 NPI number — JOHN BANCROFT HYLTON M.D,P.A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN BANCROFT HYLTON M.D,P.A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225378516
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12323 SW 55TH ST
Provider Second Line Business Mailing Address:
SUITE 1003
Provider Business Mailing Address City Name:
COOPER CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33330-3312
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-252-0083
Provider Business Mailing Address Fax Number:
954-252-0207

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12323 SW 55TH ST
Provider Second Line Business Practice Location Address:
SUITE 1003
Provider Business Practice Location Address City Name:
COOPER CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33330-3312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-252-0083
Provider Business Practice Location Address Fax Number:
954-252-0207
Provider Enumeration Date:
02/22/2013

Additional Information

Authorized Official

Authorized Official Last Name:
HYLTON
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
BANCROFT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
954-252-0083

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2300X , with the licence number: ME0060538 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 374309800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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