Individual
OTENI HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1425 MALABAR RD NE, PALM BAY, FL 32907-2506
(321) 434-8078
(321) 434-8075
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-8078
(321) 434-8075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME138074
FL
208M00000X
Hospitalist Physician
Primary
ME138074
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103602600
—
FL
01
—
QY452
MEDICARE HF
FL
Enumeration date
03/22/2016
Last updated
10/13/2023
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