Provider Demographics
NPI:1235305764
Name:HAMAKER, DEIRDRE COGAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:DEIRDRE
Middle Name:COGAN
Last Name:HAMAKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:DEIRDRE
Other - Middle Name:
Other - Last Name:COGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6615 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4056
Mailing Address - Country:US
Mailing Address - Phone:813-265-2255
Mailing Address - Fax:813-265-3355
Practice Address - Street 1:6215 ABBOTT STATION DR STE 105
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-4824
Practice Address - Country:US
Practice Address - Phone:813-782-5395
Practice Address - Fax:813-782-5331
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1411231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL364ZMedicare UPIN