Provider Demographics
NPI:1982625851
Name:HAMPTON, BRIDGETTE SOPHIA (MD)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:SOPHIA
Last Name:HAMPTON
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:PO BOX 4189
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-4189
Mailing Address - Country:US
Mailing Address - Phone:954-363-9582
Mailing Address - Fax:954-363-9663
Practice Address - Street 1:4477 MEDICAL CENTER WAY STE A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3257
Practice Address - Country:US
Practice Address - Phone:561-781-8060
Practice Address - Fax:561-781-8066
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067289207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27281UOtherPTAN
FL010738400Medicaid
FL27281OtherBLUE CROSS FLORIDA
FL010738400Medicaid