Provider Demographics
NPI:1679209951
Name:HANANIA, RITA B (DC)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:B
Last Name:HANANIA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14215 SPARTINA CT STE 300
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-3232
Mailing Address - Country:US
Mailing Address - Phone:904-257-3767
Mailing Address - Fax:
Practice Address - Street 1:14215 SPARTINA CT STE 300
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-3232
Practice Address - Country:US
Practice Address - Phone:904-257-3767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1881932754Medicaid