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General NPI Number Information
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NPI Number | 1912478454
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Entity Type | Individual
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Provider Name | MR. SEAN M HENDLEY
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Gender | Male
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 11534 ASHTON FIELD AVE
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City | RIVERVIEW
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State | FL
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Zip | 33579-2374
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Country | US
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Telephone | 813-493-1516
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Fax | 813-513-4390
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Provider Business Mailing Address
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Address Line | 11534 ASHTON FIELD AVE
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City | RIVERVIEW
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State | FL
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Zip | 33579-2374
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Country | US
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Telephone | 813-493-1516
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Fax | 813-513-4390
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Authorized Official
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Title or Position |
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Credential |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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Taxonomy #4
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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Taxonomy #5
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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Taxonomy #6
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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Taxonomy #7
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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Taxonomy #8
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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Taxonomy #9
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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