Provider Demographics
NPI:1194234187
Name:HANSHEW, JAMES JORDAN
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JORDAN
Last Name:HANSHEW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27516 CASHFORD CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6910
Mailing Address - Country:US
Mailing Address - Phone:813-406-4400
Mailing Address - Fax:813-929-6633
Practice Address - Street 1:27516 CASHFORD CIR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6910
Practice Address - Country:US
Practice Address - Phone:813-406-4400
Practice Address - Fax:813-929-6633
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110615363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant