Provider Demographics
NPI:1568828044
Name:HANNA, NAGEEB
Entity Type:Individual
Prefix:
First Name:NAGEEB
Middle Name:
Last Name:HANNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211252
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33421-1252
Mailing Address - Country:US
Mailing Address - Phone:561-827-2813
Mailing Address - Fax:
Practice Address - Street 1:2054 VISTA PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-6741
Practice Address - Country:US
Practice Address - Phone:561-827-2813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor