Provider Demographics
NPI:1104839075
Name:HASSINGER, LORI RHOADS (OD)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:RHOADS
Last Name:HASSINGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:BETH
Other - Last Name:RHOADS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:11901 4TH ST N APT 124
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1712
Mailing Address - Country:US
Mailing Address - Phone:610-310-8547
Mailing Address - Fax:
Practice Address - Street 1:1018 W BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3225
Practice Address - Country:US
Practice Address - Phone:727-585-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4167152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist