Provider Demographics
NPI:1851854632
Name:O'MALLEY, HENRY MICHAEL II (HAS, NBC-HIS)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:MICHAEL
Last Name:O'MALLEY
Suffix:II
Gender:M
Credentials:HAS, NBC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 JUNE LAKE LN
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2980
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2020 W BRANDON BLVD STE 135
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4791
Practice Address - Country:US
Practice Address - Phone:813-654-7969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist