Provider Demographics
NPI:1467480145
Name:HAN, MAOHAO (MD)
Entity Type:Individual
Prefix:
First Name:MAOHAO
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 COUNTY ROAD 44 LEG A
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3704
Mailing Address - Country:US
Mailing Address - Phone:352-323-8868
Mailing Address - Fax:352-323-8865
Practice Address - Street 1:8110 COUNTY ROAD 44 LEG A
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3704
Practice Address - Country:US
Practice Address - Phone:352-323-8868
Practice Address - Fax:352-323-8865
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94864208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275745100Medicaid
P00380949OtherRAILROAD MEDICARE
FL52939OtherBCBS
P00380949OtherRAILROAD MEDICARE
H37650Medicare UPIN