Provider Demographics
NPI:1073202990
Name:HAMMOCKS MEDICAL CARE
Entity Type:Organization
Organization Name:HAMMOCKS MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAVELLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN-DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-343-3508
Mailing Address - Street 1:10730 SW 147TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2483
Mailing Address - Country:US
Mailing Address - Phone:786-343-3508
Mailing Address - Fax:305-489-1361
Practice Address - Street 1:10730 SW 147TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196
Practice Address - Country:US
Practice Address - Phone:786-343-3508
Practice Address - Fax:305-489-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty