Provider Demographics
NPI:1023067212
Name:HANANO, MALEK (MD)
Entity type:Individual
Prefix:DR
First Name:MALEK
Middle Name:
Last Name:HANANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MALEK
Other - Middle Name:
Other - Last Name:HANANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5694 WINDHOVER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7935
Mailing Address - Country:US
Mailing Address - Phone:407-363-3449
Mailing Address - Fax:407-363-3450
Practice Address - Street 1:5694 WINDHOVER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7935
Practice Address - Country:US
Practice Address - Phone:407-363-3449
Practice Address - Fax:407-363-3450
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME28033208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0975936OtherAETNA
FL020038982OtherRR MEDICARE
FL53485OtherBCBS OF FL
FL24639OtherWELLCARE/STAYWELL/HLTEASE
FL592661887OtherUNITED HEALTHCARE
FL067007300Medicaid
FL592661887OtherUNITED HEALTHCARE
FL24639OtherWELLCARE/STAYWELL/HLTEASE