Provider Demographics
NPI:1811963630
Name:HENDRIX, RHONDA AYERS (OD)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:AYERS
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16055 EMERALD COAST PKWY UNIT 115
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-8531
Mailing Address - Country:US
Mailing Address - Phone:850-862-9543
Mailing Address - Fax:850-650-2053
Practice Address - Street 1:16055 EMERALD COAST PKWY UNIT 115
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-8531
Practice Address - Country:US
Practice Address - Phone:850-862-9543
Practice Address - Fax:850-650-2053
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI347152W00000X
ALS-621152W00000X
GA1131-T152W00000X
SC866152W00000X
FLOPC 2263152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20366ZMedicare PIN
T69118Medicare UPIN