Individual
CRAIG T HANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., P.A.
Contact information
Practice address
1489 SE 17TH ST, SUITE 2J, FT LAUDERDALE, FL 33316-1734
(954) 763-2842
(954) 763-2850
Mailing address
1489 SE 17TH ST, SUITE 2J, FT LAUDERDALE, FL 33316-1734
(954) 763-2842
(954) 763-2850
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC-1651
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57-1174449
TAX ID
FL
01
—
OP-1651
LICENSE NUMBER
FL
Enumeration date
07/17/2006
Last updated
04/05/2011
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