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General NPI Number Information
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NPI Number | 1235996166
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Entity Type | Organization
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Legal Business Name | HAMLIN CLINICAL CENTER LLC
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 2151 CONSULATE DR STE 17
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City | ORLANDO
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State | FL
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Zip | 32837-8808
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Country | US
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Telephone | 407-630-6630
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Fax |
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Provider Business Mailing Address
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Address Line | 2151 CONSULATE DR STE 17
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City | ORLANDO
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State | FL
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Zip | 32837-8808
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Country | US
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Telephone | 407-630-6630
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RAFAELA GIUNTI BASSO
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Credential | MD
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Telephone | 407-630-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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