Basic Information
Provider Information
NPI: 1255305926
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMOND
FirstName: DANIEL
MiddleName: B
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1545 9TH ST SW
Address2:  
City: VERO BEACH
State: FL
PostalCode: 329624312
CountryCode: US
TelephoneNumber: 7722578224
FaxNumber: 7722133157
Practice Location
Address1: 12196 COUNTY ROAD 512
Address2:  
City: FELLSMERE
State: FL
PostalCode: 329485463
CountryCode: US
TelephoneNumber: 7722578224
FaxNumber: 7722133157
Other Information
ProviderEnumerationDate: 02/17/2006
LastUpdateDate: 12/31/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/31/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XME 55289FLY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
5528901FLSTATE LICENSEOTHER


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