MEDICARE: NADIA HANLEY LLC

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1083422265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NADIA HANLEY LLC

Provider Business Mailing Address
First Line	:	334 2ND AVE S APT 1904
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4761
Country	:	US
Telephone Number	:	917-287-9989
Fax Number	:

Provider Business Practice Location Address
First Line	:	334 2ND AVE S APT 1904
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4761
Country	:	US
Telephone Number	:	917-287-9989
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	NADIA HANLEY
Credential	:	RD
Telephone Number	:	917-287-9989

Provider Enumeration Date	:	12/20/2024
Last Update Date	:	12/20/2024

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