Provider Demographics
NPI:1790906287
Name:HAMTAEE, ALI (DC)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:HAMTAEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28023 HWY 27
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:FL
Mailing Address - Zip Code:33838-4276
Mailing Address - Country:US
Mailing Address - Phone:863-651-7631
Mailing Address - Fax:
Practice Address - Street 1:28023 HWY 27
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:FL
Practice Address - Zip Code:33838-4276
Practice Address - Country:US
Practice Address - Phone:863-651-7631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor