Provider Demographics
NPI:1194847533
Name:HAMMOND, LESTER ALVIN III (PT)
Entity Type:Individual
Prefix:MR
First Name:LESTER
Middle Name:ALVIN
Last Name:HAMMOND
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:HAMMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:303 SE 17TH ST
Mailing Address - Street 2:#309-217
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5036 SE 110TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-3116
Practice Address - Country:US
Practice Address - Phone:352-693-3378
Practice Address - Fax:888-758-9645
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY001QOtherBLUE CROSS BLUE SHIELD
FLY001QOtherBLUE CROSS BLUE SHIELD