Hanley, Mark Raymond

Hanley, Mark Raymond is an individual health care provider with primary practice located at 1305 Valentine St , Melbourne FL 32901-3127. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Hanley, Mark Raymond can be contacted via phone (321) 254-7717.

Contact Information

Primary practice address
1305 Valentine St Melbourne FL 32901-3127
Phone: (321) 254-7717
Fax: (321) 428-4526
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME86470 Florida

Profile Details

NPI number 1063487676
LBN Legal business name Hanley, Mark Raymond
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 18th, 2006
Last updated Jul 25th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063487676 NPPES
Florida MEDICAID 267063100
Florida Other P00242439

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