MEDICARE: DR HANSON & ASSOCIATES PA

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	152WC0802X	Corneal and Contact Management Optometrist	OPC3118	FL

General Provider Information

NPI Number	:	1285957233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR HANSON & ASSOCIATES PA

Provider Business Mailing Address
First Line	:	4600 SUMMERLIN RD STE C4
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3003
Country	:	US
Telephone Number	:	239-936-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 SUMMERLIN RD STE C4
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3003
Country	:	US
Telephone Number	:	239-936-2121
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RANDAL LINN HANSON
Credential	:	O.D.
Telephone Number	:	239-936-2121

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	09/08/2010

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Directions to “DR HANSON & ASSOCIATES PA ” Practice Location

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