Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 9778 | FL |
N | 208600000X | Surgeon | 9778 | FL |
Y | 208D00000X | General Practice Physician | 9778 | FL |
NPI | 1003941709 |
---|---|
Provider Name | Mr. Edwin H Hamilton |
First Address | Pompano Beach, FL 33060 |
Second Address | Fort Lauderdale, FL 33311-3400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 09/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04796100 | (05) | FL |