Provider Demographics
NPI:1548765464
Name:HANNA, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:HANNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:14153 YOSEMITE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8065
Mailing Address - Country:US
Mailing Address - Phone:727-605-3000
Mailing Address - Fax:888-321-0917
Practice Address - Street 1:14153 YOSEMITE DR STE 104
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-8065
Practice Address - Country:US
Practice Address - Phone:727-605-3000
Practice Address - Fax:888-321-0917
Is Sole Proprietor?:No
Enumeration Date:2018-03-25
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146467207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine