Provider Demographics
NPI:1689405433
Name:MT.JOY, HALEY (PA-C)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:MT.JOY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 SLIGH BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3901
Mailing Address - Country:US
Mailing Address - Phone:407-649-6884
Mailing Address - Fax:407-245-7059
Practice Address - Street 1:1335 SLIGH BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3901
Practice Address - Country:US
Practice Address - Phone:407-649-6884
Practice Address - Fax:407-245-7059
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
FLPA9119214363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant