Provider Demographics
NPI:1437138443
Name:HANNO, RUTH H (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:H
Last Name:HANNO
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 1:15310 AMBERLY DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2199
Mailing Address - Country:US
Mailing Address - Phone:813-978-8888
Mailing Address - Fax:813-972-8974
Practice Address - Street 1:10500 UNIVERSITY CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-6497
Practice Address - Country:US
Practice Address - Phone:800-929-6694
Practice Address - Fax:813-971-6675
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47991207ZD0900X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045595400Medicaid
FL02757ZMedicare PIN
FL045595400Medicaid
FL02757WMedicare UPIN
FL02757YMedicare PIN