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General NPI Number Information
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NPI Number | 1043307929
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Entity Type | Organization
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Legal Business Name | HANLEY & HANLEY MD PA
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 401 CORBETT ST SUITE 210
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City | BELLEAIR
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State | FL
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Zip | 33756-7309
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Country | US
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Telephone | 727-443-2679
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Fax | 727-447-6411
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Provider Business Mailing Address
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Address Line | 401 CORBETT ST SUITE 210
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City | BELLEAIR
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State | FL
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Zip | 33756-7309
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Country | US
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Telephone | 727-443-2679
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Fax | 727-447-6411
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Authorized Official
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Title or Position | SEC TRES
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Name | JOHN P HANLEY III
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Credential | MD
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Telephone | 727-443-2679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME12648
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME9201
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License Number State | FL
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