MEDICARE: MR. PAUL XAVIER HAMILTON CMT, MMS

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	133N00000X	Nutritionist	45141	FL
2	173C00000X	Reflexologist	45141	FL
3	174400000X	Specialist	45141	FL
4	225700000X	Massage Therapist	45141	FL

General Provider Information

NPI Number	:	1679883649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL XAVIER HAMILTON CMT, MMS

Provider Business Mailing Address
First Line	:	3411 BARTON RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-2902
Country	:	US
Telephone Number	:	954-692-4555
Fax Number	:	954-597-6112

Provider Business Practice Location Address
First Line	:	3511 W COMMERCIAL BLVD
Second Line	:	SUITE 212
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3331
Country	:	US
Telephone Number	:	954-692-4555
Fax Number	:	954-597-6112

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

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	10/08/2010

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