Individual
MICHAEL EDWARD HAMMOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4215 EDGEWATER DR, ORLANDO, FL 32804-2206
(407) 539-2000
(407) 398-0050
Mailing address
PO BOX 4059, WAYNE, NJ 07474-4059
(973) 826-8080
(866) 309-3354
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2242
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291530800
—
FL
01
—
E1619Y
QSS SCS PTAN
FL
01
—
P00092696
RAILROAD MEDICARE
—
Enumeration date
04/04/2006
Last updated
07/21/2022
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