Healthcare Provider Details

I. General information

NPI: 1982951596
Provider Name (Legal Business Name): TAMMY LAUREN HANSON AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N FLAGLER DR SUITE 600
WEST PALM BEACH FL
33401-3428
US

IV. Provider business mailing address

124 POINCIANA DR
JUPITER FL
33458-2830
US

V. Phone/Fax

Practice location:
  • Phone: 561-659-2266
  • Fax: 561-659-7846
Mailing address:
  • Phone: 407-922-1145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1651
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAY1651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: