Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC 3710 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC 3710 | FL |
N | 152WP0200X | Pediatric Optomitrist | OPC 3710 | FL |
NPI | 1003855321 |
---|---|
Provider Name | Dr. Melissa Hannah Hammond |
First Address | Venice, FL 34285-9066 |
Second Address | University Park, FL 34201-2012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 27/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
620757000 | (05) | FL |
U92596 | (02) | FL |