Healthcare Provider Details

I. General information

NPI: 1750756045
Provider Name (Legal Business Name): MARLEEN HAMILTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16877 E COLONIAL DR STE 401
ORLANDO FL
32820-1910
US

IV. Provider business mailing address

16877 E COLONIAL DR STE 401
ORLANDO FL
32820-1910
US

V. Phone/Fax

Practice location:
  • Phone: 407-488-0796
  • Fax:
Mailing address:
  • Phone: 407-488-0796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARLEEN PULLIZA HAMILTON
Title or Position: OWNER
Credential:
Phone: 407-488-0796