Provider Demographics
NPI:1821607318
Name:SHIHADA, HANAN
Entity Type:Individual
Prefix:
First Name:HANAN
Middle Name:
Last Name:SHIHADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 CALVANO DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-5478
Mailing Address - Country:US
Mailing Address - Phone:813-735-0029
Mailing Address - Fax:
Practice Address - Street 1:3433 LITHIA PINECREST RD STE 135
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6302
Practice Address - Country:US
Practice Address - Phone:813-391-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist