Provider Demographics
NPI:1578380838
Name:STARR, HANNAH MARIE (OD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:STARR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:WALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5593 STEWART ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-4344
Mailing Address - Country:US
Mailing Address - Phone:850-623-0319
Mailing Address - Fax:850-626-9686
Practice Address - Street 1:5593 STEWART ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4344
Practice Address - Country:US
Practice Address - Phone:850-623-0319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6552152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist