Provider Demographics
NPI:1205938545
Name:HAMER, JEFFERY T (ATC, LAT, CSCS)
Entity type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:T
Last Name:HAMER
Suffix:
Gender:M
Credentials:ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4073 ARDMORE LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-5030
Mailing Address - Country:US
Mailing Address - Phone:941-232-3944
Mailing Address - Fax:
Practice Address - Street 1:1 RAM WAY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5141
Practice Address - Country:US
Practice Address - Phone:941-232-3944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer