Provider Demographics
NPI:1811959570
Name:RETINA ASSOCIATES OF FLORIDA, P.A.
Entity type:Organization
Organization Name:RETINA ASSOCIATES OF FLORIDA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-875-6373
Mailing Address - Street 1:602 S MACDILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4614
Mailing Address - Country:US
Mailing Address - Phone:813-875-6373
Mailing Address - Fax:813-876-0960
Practice Address - Street 1:602 S MACDILL AVENUE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4614
Practice Address - Country:US
Practice Address - Phone:813-875-6373
Practice Address - Fax:813-876-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38722OtherBCBS
FL38722OtherBCBS