Organization
HANLEY PAIN AND REHABILITATION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSH MAYWALT (BILLING MANAGER)
(407) 352-1030
Entity
Organization
Contact information
Practice address
5979 VINELAND RD, SUITE 209, ORLANDO, FL 32819-7800
(407) 352-1030
(407) 352-2884
Mailing address
5979 VINELAND RD, SUITE 209, ORLANDO, FL 32819-7800
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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