Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME0069749 | FL |
N | 111NI0900X | Internist | ME0069749 | FL |
Y | 207RA0401X | Internist - Addiction Medicine | ME0069749 | FL |
NPI | 1881675999 |
---|---|
Provider Name | Dr. Allison W Hanley |
First Address | Orlando, FL 32835-6216 |
Second Address | Orlando, FL 32835-6216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 28/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250015900 | (05) | FL |
28914 | BLUE CROSS PROVIDER # (01) | FL |
28914V | MEDICARE PTAN - FL (01) | FL |
F67953 | (02) | FL |