# HANLEY PAIN AND REHABILITATION CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518140425
- **Authorized official:** MR. JOSH MAYWALT (BILLING MANAGER)
- **Authorized official phone:** (407) 352-1030

## Contact information

- **Practice address:** 5979 VINELAND RD, SUITE 209, ORLANDO, FL 32819-7800
- **Practice address phone:** (407) 352-1030
- **Practice address fax:** (407) 352-2884
- **Mailing address:** 5979 VINELAND RD, SUITE 209, ORLANDO, FL 32819-7800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 12/13/2007
- **Last updated:** 12/13/2007