MEDICARE: EDWIN H HAMILTON PA

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	207Q00000X	Family Medicine Physician	ME9778	FL

General Provider Information

NPI Number	:	1700205770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDWIN H HAMILTON PA

Provider Business Mailing Address
First Line	:	401 NE FIRST STREET
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060
Country	:	US
Telephone Number	:	954-484-8333
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 NW 19TH ST
Second Line	:	SUITE 2
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-3400
Country	:	US
Telephone Number	:	954-484-8333
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. EDWIN H HAMILTON
Credential	:	MD
Telephone Number	:	954-484-8333

Provider Enumeration Date	:	04/07/2014
Last Update Date	:	05/09/2017

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