Provider Demographics
NPI:1346846193
Name:HANNA, KORKAR E SR (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:KORKAR
Middle Name:E
Last Name:HANNA
Suffix:SR
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3250 N JOHN YOUNG PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7549
Mailing Address - Country:US
Mailing Address - Phone:407-933-0947
Mailing Address - Fax:407-933-1776
Practice Address - Street 1:8209 VIA VIVALDI
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-7703
Practice Address - Country:US
Practice Address - Phone:407-782-7007
Practice Address - Fax:407-601-2022
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist