Provider Demographics
NPI:1144398397
Name:MELISSA H. HAMMOND, O.D., P.A.
Entity Type:Organization
Organization Name:MELISSA H. HAMMOND, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:HANNAH
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-351-9440
Mailing Address - Street 1:8433 TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2868
Mailing Address - Country:US
Mailing Address - Phone:941-351-9440
Mailing Address - Fax:941-351-9446
Practice Address - Street 1:8433 TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2868
Practice Address - Country:US
Practice Address - Phone:941-351-9440
Practice Address - Fax:941-351-9446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3710152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620757000Medicaid
FL4888830001Medicare PIN
FLU92596Medicare UPIN
FL620757000Medicaid