Provider Demographics
NPI:1164298626
Name:HANNA, MINA (DC)
Entity Type:Individual
Prefix:
First Name:MINA
Middle Name:
Last Name:HANNA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10635 PONTOFINO CIR
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-7061
Mailing Address - Country:US
Mailing Address - Phone:727-333-5318
Mailing Address - Fax:
Practice Address - Street 1:10635 PONTOFINO CIR
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-7061
Practice Address - Country:US
Practice Address - Phone:727-333-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor