Provider Demographics
NPI:1043226822
Name:HANNA, NADIA F (MD)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:F
Last Name:HANNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21806
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34276-4806
Mailing Address - Country:US
Mailing Address - Phone:941-922-1400
Mailing Address - Fax:877-645-3318
Practice Address - Street 1:3333 CLARK RD
Practice Address - Street 2:SUITE 190
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8432
Practice Address - Country:US
Practice Address - Phone:941-922-1400
Practice Address - Fax:877-645-3318
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006018978207Q00000X
FLME111746207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005833500Medicaid
FL14LF8OtherBCBS OF FL
FLGH466ZMedicare PIN