Provider Demographics
NPI:1790747020
Name:JAMES A. HALEY VA HOSPITAL
Entity Type:Organization
Organization Name:JAMES A. HALEY VA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OF STAFF
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:CUTOLO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:813-972-2000
Mailing Address - Street 1:34404 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5228
Mailing Address - Country:US
Mailing Address - Phone:813-715-0999
Mailing Address - Fax:
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:NURSING 118-A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:813-978-5933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9212853282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital