Individual
HALEY HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5215 E STATE ROAD 64, BRADENTON, FL 34208-5533
(941) 907-3400
(941) 907-4202
Mailing address
6131 164TH AVE E, PARRISH, FL 34219-4305
(941) 779-5339
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9115721
FL
Other
Enumeration date
04/05/2022
Last updated
02/26/2025
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