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General NPI Number Information
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NPI Number | 1548455074
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Entity Type | Organization
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Legal Business Name | JOSEPH J HATALA OD PA
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 27001 US HIGHWAY 19 N SUITE 2004
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City | CLEARWATER
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State | FL
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Zip | 33761-3402
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Country | US
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Telephone | 727-669-6369
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Fax |
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Provider Business Mailing Address
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Address Line | 27001 US HIGHWAY 19 N SUITE 2004
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City | CLEARWATER
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State | FL
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Zip | 33761-3402
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Country | US
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Telephone | 727-669-6369
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH J HATALA
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Credential | OD
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Telephone | 727-669-6369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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