Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT18085 | FL |
NPI | 1750409751 |
---|---|
Provider Name | Ms. Nicole Suzanne Hamel |
First Address | Seminole, FL 33772-4128 |
Second Address | Seminole, FL 33772-4128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 27/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CO9272 | MEDICARE CO9272 (01) | FL |