MEDICARE: HALEY MICHAEL ANDERSON

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	1041S0200X	School Social Worker		FL

General Provider Information

NPI Number	:	1023805561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY MICHAEL ANDERSON

Provider Business Mailing Address
First Line	:	156 44TH AVE NE
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33703-4926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	156 44TH AVE NE
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33703-4926
Country	:	US
Telephone Number	:	727-482-4360
Fax Number	:

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

Provider Enumeration Date	:	04/21/2025
Last Update Date	:	05/06/2025

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Directions to “ HALEY MICHAEL ANDERSON ” Practice Location

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