MEDICARE: MR. JAMES HANLON AP

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
1	171100000X	Acupuncturist	AP1251	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C0562	OTHER	FL	BLUS CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1023250651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES HANLON AP

Provider Business Mailing Address
First Line	:	2247 PALM BEACH LAKES BLVD
Second Line	:	204B
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3470
Country	:	US
Telephone Number	:	561-833-7618
Fax Number	:

Provider Business Practice Location Address
First Line	:	2247 PALM BEACH LAKES BLVD
Second Line	:	204B
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3470
Country	:	US
Telephone Number	:	561-833-7618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2009
Last Update Date	:	01/23/2013

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