MEDICARE: WAYNE E HALL PA-C

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	363A00000X	Physician Assistant

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HP166Z	OTHER	FL	MEDICARE PTAN
2	P01590368	OTHER	FL	MEDICARE RAILROAD PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1033412358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAYNE E HALL PA-C

Provider Business Mailing Address
First Line	:	5833 S GOLDENROD RD STE 5C&D
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-8777
Country	:	US
Telephone Number	:	407-810-8777
Fax Number	:	407-658-0721

Provider Business Practice Location Address
First Line	:	5833 S GOLDENROD RD STE 5C&D
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-8777
Country	:	US
Telephone Number	:	407-810-8777
Fax Number	:	407-658-0721

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

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	03/06/2023

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Directions to “ WAYNE E HALL PA-C” Practice Location

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