Provider Demographics
NPI:1235996166
Name:HAMLIN CLINICAL CENTER LLC
Entity type:Organization
Organization Name:HAMLIN CLINICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAFAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIUNTI BASSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-630-6630
Mailing Address - Street 1:2151 CONSULATE DR STE 17
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8808
Mailing Address - Country:US
Mailing Address - Phone:407-630-6630
Mailing Address - Fax:
Practice Address - Street 1:2151 CONSULATE DR STE 17
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8808
Practice Address - Country:US
Practice Address - Phone:407-630-6630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care