Provider Demographics
NPI:1285975599
Name:HAMBERLIN, ALANA J
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:J
Last Name:HAMBERLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 DOUGLAS AVE
Mailing Address - Street 2:STE 185
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-5210
Mailing Address - Country:US
Mailing Address - Phone:407-703-5959
Mailing Address - Fax:
Practice Address - Street 1:821 DOUGLAS AVE
Practice Address - Street 2:STE 185
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5210
Practice Address - Country:US
Practice Address - Phone:407-703-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003564600Medicaid