Provider Demographics
NPI:1871142133
Name:HANDLEY HEALTH LLC
Entity type:Organization
Organization Name:HANDLEY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-833-5627
Mailing Address - Street 1:4018 W GRANADA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-6710
Mailing Address - Country:US
Mailing Address - Phone:813-833-5627
Mailing Address - Fax:866-451-4607
Practice Address - Street 1:104 E FLETCHER AVE STE F
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3429
Practice Address - Country:US
Practice Address - Phone:813-416-8450
Practice Address - Fax:866-451-4607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty