Basic Information
| Provider Information | |||||||||
| NPI: | 1538415245 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES A. HALEY VA HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2510 CULBREATH COVE CT | ||||||||
| Address2: | |||||||||
| City: | VALRICO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335966387 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8133813495 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13000-BRUCE B. DOWNS BLVD | ||||||||
| Address2: | JAMES A. HALEY VA HOSPITAL | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139722000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2012 | ||||||||
| LastUpdateDate: | 07/31/2012 | ||||||||
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| AuthorizedOfficialLastName: | PROCTOR | ||||||||
| AuthorizedOfficialFirstName: | CAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | NURSE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8139722000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | ARNP9214717 | FL | Y | Hospitals | General Acute Care Hospital |
No ID Information.