Provider Demographics
NPI:1801000971
Name:HAMILTON, CELINE ALYSSA (MD)
Entity Type:Individual
Prefix:DR
First Name:CELINE
Middle Name:ALYSSA
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5865
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1150 N 35TH AVE STE 560
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5431
Practice Address - Country:US
Practice Address - Phone:954-265-1370
Practice Address - Fax:954-265-1375
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2020-02-06
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2008-06-13
Provider Licenses
StateLicense IDTaxonomies
NY242821208000000X, 2084P0804X
FLME1349452084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics