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General NPI Number Information
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NPI Number | 1629754007
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Entity Type | Individual
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Provider Name | OLIVIA MERCEDES HEMILTON
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Gender | Female
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 1726 DAVENPORT DR
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-4228
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Country | US
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Telephone | 727-493-2393
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Fax |
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Provider Business Mailing Address
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Address Line | 2327 SHIRECREST COVE WAY
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City | LUTZ
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State | FL
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Zip | 33558-4911
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Country | US
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Telephone | 727-271-6032
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Fax |
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI6370
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License Number State | FL
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