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General NPI Number Information
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NPI Number | 1124622972
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Entity Type | Individual
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Provider Name | ELYSE MARIE HAMILTON APRN
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 12/05/2021
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Provider Practice Location Address
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Address Line | 228 W ALEXANDER ST
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City | PLANT CITY
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State | FL
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Zip | 33563-7157
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Country | US
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Telephone | 813-754-5480
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 400
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City | MIAMI
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State | FL
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Zip | 33126-2051
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Country | US
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Telephone | 561-570-5172
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Fax | 786-472-5770
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11006587
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License Number State | FL
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