Provider Demographics
NPI:1073754487
Name:HAMILTON, WILLIAM J (LMT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S OAKLAND FOREST DR
Mailing Address - Street 2:#2202
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-7531
Mailing Address - Country:US
Mailing Address - Phone:954-770-2655
Mailing Address - Fax:
Practice Address - Street 1:2350 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 650
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1419
Practice Address - Country:US
Practice Address - Phone:954-731-8097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 44029225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist