Provider Demographics
NPI:1013248996
Name:HAMVAS, RANIA (MD)
Entity Type:Individual
Prefix:
First Name:RANIA
Middle Name:
Last Name:HAMVAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3583 RIVER HEIGHTS XING SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4898
Mailing Address - Country:US
Mailing Address - Phone:813-972-1030
Mailing Address - Fax:813-972-2224
Practice Address - Street 1:18101 HIGHWOODS PRESERVE PKWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1791
Practice Address - Country:US
Practice Address - Phone:813-972-1030
Practice Address - Fax:813-972-2224
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-17
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103355207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E28239Medicare UPIN