Provider Demographics
NPI:1619082237
Name:HAMMERLING-HODGERS, SUSAN (PA-C, MPAS, DFAAPA)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:HAMMERLING-HODGERS
Suffix:
Gender:F
Credentials:PA-C, MPAS, DFAAPA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:HAMMERLING-HODGERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:900 VILLAGE SQUARE XING STE 290
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4552
Mailing Address - Country:US
Mailing Address - Phone:239-360-2792
Mailing Address - Fax:239-666-9211
Practice Address - Street 1:8045 SPYGLASS HILL RD STE 104
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8567
Practice Address - Country:US
Practice Address - Phone:321-294-5800
Practice Address - Fax:321-241-4578
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101668363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6060ZMedicare PIN
P38265Medicare UPIN