Provider Demographics
NPI:1790784833
Name:HAMMERLI, JOHN JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:HAMMERLI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10279 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-4331
Mailing Address - Country:US
Mailing Address - Phone:407-273-7270
Mailing Address - Fax:407-273-7371
Practice Address - Street 1:10279 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4331
Practice Address - Country:US
Practice Address - Phone:407-273-7270
Practice Address - Fax:407-273-7371
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL889152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL084491800Medicaid
FL084491800Medicaid
T93840Medicare UPIN