Provider Demographics
NPI:1093100505
Name:EL SHAKANKIRY, HANAN MOSTAFA
Entity Type:Individual
Prefix:
First Name:HANAN
Middle Name:MOSTAFA
Last Name:EL SHAKANKIRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANAN
Other - Middle Name:
Other - Last Name:EL SHAKANKIRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MSC, PHD
Mailing Address - Street 1:PO BOX 100296
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0296
Mailing Address - Country:US
Mailing Address - Phone:352-273-8920
Mailing Address - Fax:352-392-9802
Practice Address - Street 1:1601 CENTER ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1541
Practice Address - Country:US
Practice Address - Phone:251-660-5108
Practice Address - Fax:251-660-5792
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1643272084E0001X, 2084N0600X, 2084N0402X
ALMD.448102084N0402X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program