Provider Demographics
NPI:1659603678
Name:BANI HANI, MURAD (MD)
Entity Type:Individual
Prefix:
First Name:MURAD
Middle Name:
Last Name:BANI HANI
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 1:1541 SW 1ST AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6506
Mailing Address - Country:US
Mailing Address - Phone:352-622-8152
Mailing Address - Fax:352-622-4408
Practice Address - Street 1:1541 SW 1ST AVE STE 105
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6506
Practice Address - Country:US
Practice Address - Phone:352-622-8152
Practice Address - Fax:352-622-4408
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20195208600000X
MDP24855208600000X
FLME141211208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery