Individual
THEODORE HANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10601 GANDY BLVD N APT 4302, SAINT PETERSBURG, FL 33702-1505
(917) 821-5813
Mailing address
10601 GANDY BLVD N APT 4302, SAINT PETERSBURG, FL 33702-1505
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
187032
NY
207L00000X
Anesthesiology Physician
Primary
ME136477
FL
Other
Enumeration date
05/20/2006
Last updated
09/27/2023
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