1477756450 NPI number — MR. WILLIAM LEONARD HOGAN LMFT

Table of content: MR. WILLIAM LEONARD HOGAN LMFT (NPI 1477756450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477756450 NPI number — MR. WILLIAM LEONARD HOGAN LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOGAN
Provider First Name:
WILLIAM
Provider Middle Name:
LEONARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOGAN
Provider Other First Name:
WILLIAM
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1477756450
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14707 CARNATION DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33613-1807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-961-1995
Provider Business Mailing Address Fax Number:
813-908-6232

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3750 GUNN HWY
Provider Second Line Business Practice Location Address:
SUITE 1-D
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-265-9616
Provider Business Practice Location Address Fax Number:
813-908-6232
Provider Enumeration Date:
06/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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