Provider Demographics
NPI:1164495305
Name:GUIRGUIS, HANY SOBHY (MD)
Entity Type:Individual
Prefix:DR
First Name:HANY
Middle Name:SOBHY
Last Name:GUIRGUIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11406
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4005
Mailing Address - Country:US
Mailing Address - Phone:321-636-2621
Mailing Address - Fax:321-631-9436
Practice Address - Street 1:1317 W POINT DR
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-6464
Practice Address - Country:US
Practice Address - Phone:321-636-2621
Practice Address - Fax:321-631-9436
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL88173207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269253800Medicaid
FLH94740Medicare UPIN
FL269253800Medicaid