Provider Demographics
NPI:1043307929
Name:HANLEY & HANLEY MD PA
Entity type:Organization
Organization Name:HANLEY & HANLEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC TRES
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HANLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:727-443-2679
Mailing Address - Street 1:401 CORBETT ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BELLEAIR
Mailing Address - State:FL
Mailing Address - Zip Code:33756-7309
Mailing Address - Country:US
Mailing Address - Phone:727-443-2679
Mailing Address - Fax:727-447-6411
Practice Address - Street 1:401 CORBETT ST
Practice Address - Street 2:SUITE 210
Practice Address - City:BELLEAIR
Practice Address - State:FL
Practice Address - Zip Code:33756-7309
Practice Address - Country:US
Practice Address - Phone:727-443-2679
Practice Address - Fax:727-447-6411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME9201208000000X
FLME12648208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56175Medicare UPIN
D56174Medicare UPIN