MEDICARE: MS. JOANN HAUSER ATC

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	2255A2300X	Athletic Trainer	AL 1408	FL

General Provider Information

NPI Number	:	1154504066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANN HAUSER ATC

Provider Business Mailing Address
First Line	:	11230 RANCH CREEK TER APT 212
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34211-4028
Country	:	US
Telephone Number	:	863-838-6992
Fax Number	:

Provider Business Practice Location Address
First Line	:	4539 S DALE MABRY HWY STE 101
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1404
Country	:	US
Telephone Number	:	813-250-1208
Fax Number	:

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

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	12/17/2023

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