Provider Demographics
NPI:1437636024
Name:HAMMOND, TONIA
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 BEECHWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-1224
Mailing Address - Country:US
Mailing Address - Phone:813-622-8606
Mailing Address - Fax:813-622-8606
Practice Address - Street 1:3819 BEECHWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-1224
Practice Address - Country:US
Practice Address - Phone:813-622-8606
Practice Address - Fax:813-622-8606
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906953311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home