Provider Demographics
NPI:1306900063
Name:JANINE HANSON DBA JANINE HANSON RPT
Entity type:Organization
Organization Name:JANINE HANSON DBA JANINE HANSON RPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:727-541-2091
Mailing Address - Street 1:8130 66TH ST
Mailing Address - Street 2:SUITE #12
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2111
Mailing Address - Country:US
Mailing Address - Phone:727-541-2091
Mailing Address - Fax:727-545-0503
Practice Address - Street 1:8130 66TH ST
Practice Address - Street 2:SUITE #12
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2111
Practice Address - Country:US
Practice Address - Phone:727-541-2091
Practice Address - Fax:727-545-0503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLST 12452251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty