Healthcare Provider Details

I. General information

NPI: 1134290679
Provider Name (Legal Business Name): JAMES A HALEY VA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD
TAMPA FL
33612-4745
US

IV. Provider business mailing address

22520 EAGLES WATCH DR
LAND O LAKES FL
34639-6773
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax:
Mailing address:
  • Phone: 813-469-1955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License NumberRT 3850
License Number StateFL

VIII. Authorized Official

Name: MR. ELLIOT ECHEVARRIA
Title or Position: RESP THERAPIST
Credential: RRT
Phone: 813-469-1955