Provider Demographics
NPI:1023250651
Name:HANLON, JAMES (AP)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:HANLON
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2247 PALM BEACH LAKES BLVD
Mailing Address - Street 2:204B
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3470
Mailing Address - Country:US
Mailing Address - Phone:561-833-7618
Mailing Address - Fax:
Practice Address - Street 1:2247 PALM BEACH LAKES BLVD
Practice Address - Street 2:204B
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3470
Practice Address - Country:US
Practice Address - Phone:561-833-7618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1251171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC0562OtherBLUS CROSS BLUE SHIELD