1639489883 NPI number — DR. MICHAEL HAY AND ASSOCIATES, LLC

Table of content: (NPI 1639489883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639489883 NPI number — DR. MICHAEL HAY AND ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. MICHAEL HAY AND ASSOCIATES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639489883
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
530 AMBERWOOD COURT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGE PARK
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-535-8232
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5517 S. WILLIAMSON BLVD.
Provider Second Line Business Practice Location Address:
#310
Provider Business Practice Location Address City Name:
PORT ORANGE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-760-1896
Provider Business Practice Location Address Fax Number:
386-788-8893
Provider Enumeration Date:
10/20/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAY
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
905-535-8232

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OPC2791 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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