Provider Demographics
NPI:1598720039
Name:GUIRGIS, HANY HESHMAT (MD)
Entity Type:Individual
Prefix:DR
First Name:HANY
Middle Name:HESHMAT
Last Name:GUIRGIS
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 1:1765 BERGLUND LN STE 1
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6230
Mailing Address - Country:US
Mailing Address - Phone:321-421-7544
Mailing Address - Fax:321-421-7543
Practice Address - Street 1:1765 BERGLUND LN STE 1
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6230
Practice Address - Country:US
Practice Address - Phone:321-421-7544
Practice Address - Fax:321-421-7543
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92238207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64091663Medicaid
OH2529473Medicaid
WV3810001373Medicaid
FL003593300Medicaid
WV3810001373Medicaid
OH2529473Medicaid