Provider Demographics
NPI:1790343572
Name:HANNA, AFIF AMER (MD)
Entity Type:Individual
Prefix:
First Name:AFIF
Middle Name:AMER
Last Name:HANNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AFIF
Other - Middle Name:AMER
Other - Last Name:ABU-HANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2505 JUNIOR ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8000
Mailing Address - Country:US
Mailing Address - Phone:386-960-8282
Mailing Address - Fax:
Practice Address - Street 1:2505 JUNIOR ST
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8000
Practice Address - Country:US
Practice Address - Phone:386-960-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME156799208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program