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General NPI Number Information
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NPI Number | 1043473283
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Entity Type | Organization
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Legal Business Name | JAMES A HALEY
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 529 S PARSONS AVE APT#1014
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City | BRANDON
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State | FL
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Zip | 33511-6069
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Country | US
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Telephone | 813-300-3098
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Fax |
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Provider Business Mailing Address
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Address Line | 529 S PARSONS AVE APT#1014
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City | BRANDON
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State | FL
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Zip | 33511-6069
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Country | US
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Telephone | 813-300-3098
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Fax |
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Authorized Official
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Title or Position | LICSENCED PRACTICAL NURSE
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Name | MRS. RACHELL JEANETTE FLORES
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Credential | LPN
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Telephone | 813-300-3098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number | PN5181692
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License Number State | FL
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