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Individual

HOMER PAUL HATTEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1485 37TH ST, SUITE 107, VERO BEACH, FL 32960-6500
(772) 569-9745
(772) 567-6868
Mailing address
111 TWIN ISLAND REACH, VERO BEACH, FL 32963-3909
(772) 231-3453
(772) 231-8986

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
ME0076679
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME0076679
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
262748500
FL
Enumeration date
07/20/2005
Last updated
06/03/2008
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