Provider Demographics
NPI:1760099022
Name:HAYES, HALEY (PT, DPT, CERT MDT)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:PT, DPT, CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PENLEY LAKE CIR UNIT 303
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-1571
Mailing Address - Country:US
Mailing Address - Phone:816-718-4000
Mailing Address - Fax:
Practice Address - Street 1:80 HANCOCK BRIDGE PKWY W STE G22
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2093
Practice Address - Country:US
Practice Address - Phone:419-221-6717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT41620225100000X
MO2020025346225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist