Provider Demographics
NPI:1326211970
Name:HANLEY, JAMES A
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:HANLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3448 JEWISH DRIVE
Mailing Address - Street 2:
Mailing Address - City:HERNANDO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34607
Mailing Address - Country:US
Mailing Address - Phone:352-688-9157
Mailing Address - Fax:
Practice Address - Street 1:3101 37TH AVE N
Practice Address - Street 2:SUITE A
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-1509
Practice Address - Country:US
Practice Address - Phone:727-328-0599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA9890224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant