Provider Demographics
NPI:1215800909
Name:HAMILTON, KARNESIA R
Entity type:Individual
Prefix:
First Name:KARNESIA
Middle Name:R
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 1:954 BENTSTATION LN APT 402
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2271
Mailing Address - Country:US
Mailing Address - Phone:281-669-7928
Mailing Address - Fax:
Practice Address - Street 1:954 BENTSTATION LN APT 402
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2271
Practice Address - Country:US
Practice Address - Phone:281-669-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center