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SAMUEL HATHY III,O.D.
NPI 1801191960
Eyewear Supplier in Jacksonville, FL

Active since January 21, 2011
11111 SAN JOSE BLVD STE 44, JACKSONVILLE, FL 32223(904) 292-3976(904) 292-5322 Get Directions Write a Review

NPPES record last updated: January 21, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samuel Hathy Iii,o.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL HATHY III,O.D. (NPI 1801191960) is a healthcare organization registered as an eyewear supplier in Jacksonville, Florida and active in the NPI registry since January 2011. The organization lists Samuel Hathy, Doctor, as its authorized official.

NPPES Registry Identity

NPI1801191960
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSAMUEL HATHY III,O.D.
Location Address11111 SAN JOSE BLVD STE 44Jacksonville, FL 32223-7274
Mailing Address11111-44 San Jose BlvdJacksonville, FL 32223 · (904) 292-3976 · Fax (904) 292-5322
Phone(904) 292-3976
Fax(904) 292-5322
Organization SubpartNo
Authorized OfficialSamuel HathyDoctor · (904) 292-3976
Enumeration DateJanuary 21, 2011
✔ NPI 1801191960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
License✔ Licensed in FL · FL-OPC-2361
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
11111 SAN JOSE BLVD STE 44, Jacksonville, FL 32223
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Other Identifiers 2

Medicare PIN20163FL
Medicare UPINU05440FL

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. FLORA CHEN POVEDA O.D.
Optometrist
11111 SAN JOSE BLVD STE 44
JACKSONVILLE, FL 32223
Duval County (904) 292-3976

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Hathy Iii,o.D.'s NPI number?

The NPI number for Samuel Hathy Iii,o.D. is 1801191960. It was assigned to this organization in the NPPES registry on January 21, 2011.

Where is Samuel Hathy Iii,o.D. located?

Samuel Hathy Iii,o.D. is located at 11111 San Jose Blvd Ste 44, Jacksonville, FL 32223. The listed phone number is (904) 292-3976.

What is Samuel Hathy Iii,o.D.'s specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Samuel Hathy Iii,o.D. was last updated on January 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.