MEDICARE: MICHELLE L HAMILTON

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1336080076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE L HAMILTON

Provider Business Mailing Address
First Line	:	461 LARINO RD SW
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32908-4726
Country	:	US
Telephone Number	:	321-346-3761
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 E MELBOURNE AVE STE D
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-5976
Country	:	US
Telephone Number	:	321-677-2222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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