Healthcare Provider Details

I. General information

NPI: 1083635569
Provider Name (Legal Business Name): DANIEL L HACHEY O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 TARPON BAY BLVD UNIT 1
NAPLES FL
34119-8764
US

IV. Provider business mailing address

27028 BELLE RIO DR
BONITA SPRINGS FL
34135-4427
US

V. Phone/Fax

Practice location:
  • Phone: 239-206-1192
  • Fax: 239-206-1192
Mailing address:
  • Phone: 239-687-6868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPC3071
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC3071
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberOPC3071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: