Provider Demographics
NPI:1457415101
Name:HANSON, JANINE (RPT)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8130 66TH ST
Mailing Address - Street 2:SUITE #12
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2111
Mailing Address - Country:US
Mailing Address - Phone:727-541-2091
Mailing Address - Fax:727-545-0503
Practice Address - Street 1:8130 66TH ST
Practice Address - Street 2:SUITE #12
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2111
Practice Address - Country:US
Practice Address - Phone:727-541-2091
Practice Address - Fax:727-545-0503
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 12452251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics