Provider Demographics
NPI:1467963876
Name:HAMILTON, FERQUANZA V
Entity Type:Individual
Prefix:
First Name:FERQUANZA
Middle Name:V
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 ROSAMOND DR APT 3215
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-0937
Mailing Address - Country:US
Mailing Address - Phone:407-765-6402
Mailing Address - Fax:
Practice Address - Street 1:5100 ROSAMOND DR APT 3215
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-0937
Practice Address - Country:US
Practice Address - Phone:407-765-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235001376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker