Provider Demographics
NPI:1083635569
Name:HACHEY, DANIEL L (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:HACHEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27028 BELLE RIO DR
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4427
Mailing Address - Country:US
Mailing Address - Phone:239-687-6868
Mailing Address - Fax:
Practice Address - Street 1:2415 TARPON BAY BLVD UNIT 1
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8764
Practice Address - Country:US
Practice Address - Phone:239-206-1192
Practice Address - Fax:239-206-1192
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3071152WC0802X, 152W00000X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20797OtherBLUE CROSS BLUE SHIELD NO
FL64722OtherOPTUM HEALTH
FL20797OtherBLUE CROSS BLUE SHIELD NO
FL64722OtherOPTUM HEALTH
FL20797AMedicare PIN