MEDICARE: HANDLEY HEALTH 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1871142133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANDLEY HEALTH LLC

Provider Business Mailing Address
First Line	:	4018 W GRANADA ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-6710
Country	:	US
Telephone Number	:	813-833-5627
Fax Number	:	866-451-4607

Provider Business Practice Location Address
First Line	:	104 E FLETCHER AVE STE F
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-3429
Country	:	US
Telephone Number	:	813-416-8450
Fax Number	:	866-451-4607

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL HANDLEY
Credential	:	APRN
Telephone Number	:	813-833-5627

Provider Enumeration Date	:	09/10/2019
Last Update Date	:	09/10/2019

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Directions to “HANDLEY HEALTH LLC ” Practice Location

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