Provider Demographics
NPI:1497558894
Name:FETYAN, HANEEN S (MD)
Entity type:Individual
Prefix:
First Name:HANEEN
Middle Name:S
Last Name:FETYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HANEEN
Other - Middle Name:SABAH MUNEER
Other - Last Name:FETYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1200 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1300
Mailing Address - Country:US
Mailing Address - Phone:813-586-6993
Mailing Address - Fax:
Practice Address - Street 1:1200 7TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1300
Practice Address - Country:US
Practice Address - Phone:813-586-6993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program