MEDICARE: JOSEPH J HATALA OD 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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1548455074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH J HATALA OD PA

Provider Business Mailing Address
First Line	:	27001 US HIGHWAY 19 N
Second Line	:	SUITE 2004
City	:	CLEARWATER
State	:	FL
Zip	:	33761-3402
Country	:	US
Telephone Number	:	727-669-6369
Fax Number	:

Provider Business Practice Location Address
First Line	:	27001 US HIGHWAY 19 N
Second Line	:	SUITE 2004
City	:	CLEARWATER
State	:	FL
Zip	:	33761-3402
Country	:	US
Telephone Number	:	727-669-6369
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH J HATALA
Credential	:	OD
Telephone Number	:	727-669-6369

Provider Enumeration Date	:	09/07/2007
Last Update Date	:	09/07/2007

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