Provider Demographics
NPI:1851491427
Name:TODD C. HARTLEY, M.D., P.A.
Entity type:Organization
Organization Name:TODD C. HARTLEY, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-673-3737
Mailing Address - Street 1:PO BOX 150187
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32715-0187
Mailing Address - Country:US
Mailing Address - Phone:407-673-3737
Mailing Address - Fax:407-831-6838
Practice Address - Street 1:251 MAITLAND AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4914
Practice Address - Country:US
Practice Address - Phone:407-673-3737
Practice Address - Fax:407-831-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty