MEDICARE: MISS JENNIFER ANN HAMILTON MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA5998	FL

General Provider Information

NPI Number	:	1407171838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNIFER ANN HAMILTON MA

Provider Business Mailing Address
First Line	:	2328 HANCOCK BRIDGE PKWY STE 101
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-1455
Country	:	US
Telephone Number	:	239-246-8751
Fax Number	:	239-220-5610

Provider Business Practice Location Address
First Line	:	2328 HANCOCK BRIDGE PKWY STE 101
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-1455
Country	:	US
Telephone Number	:	239-246-8751
Fax Number	:	239-220-5610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	11/28/2023

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