Provider Demographics
NPI:1376858266
Name:RENEE HANEY MD PA
Entity Type:Organization
Organization Name:RENEE HANEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-224-0355
Mailing Address - Street 1:718 W MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-3135
Mailing Address - Country:US
Mailing Address - Phone:813-224-0355
Mailing Address - Fax:
Practice Address - Street 1:718 W MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 100A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-3135
Practice Address - Country:US
Practice Address - Phone:813-224-0355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty