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NPI Code Detail

MEDICARE: DR. LOGAN FREDRIK HANSON D.O

MEDICARE: DR. LOGAN FREDRIK HANSON D.O
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianOS19241FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013350032
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOGAN FREDRIK HANSON D.O
Provider Business Mailing Address
First Line : 3000 WOODMONT AVE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-3800
Country : US
Telephone Number : 863-293-1191
Fax Number :
Provider Business Practice Location Address
First Line : 3000 WOODMONT AVE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-3800
Country : US
Telephone Number : 863-293-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2013
Last Update Date : 11/19/2025

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