Provider Demographics
NPI:1851566277
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:REGISTERED RESPIRATORY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIA
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:727-610-7297
Mailing Address - Street 1:1329 52ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-3220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1329 52ND AVE NE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-3220
Practice Address - Country:US
Practice Address - Phone:813-610-7297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-26
Last Update Date:2008-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6082286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital