Provider Demographics
NPI:1043473283
Name:JAMES A HALEY
Entity Type:Organization
Organization Name:JAMES A HALEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSENCED PRACTICAL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHELL
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:813-300-3098
Mailing Address - Street 1:529 S PARSONS AVE
Mailing Address - Street 2:APT#1014
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6069
Mailing Address - Country:US
Mailing Address - Phone:813-300-3098
Mailing Address - Fax:
Practice Address - Street 1:529 S PARSONS AVE
Practice Address - Street 2:APT#1014
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6069
Practice Address - Country:US
Practice Address - Phone:813-300-3098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN51816922865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital