Provider Demographics
NPI:1801887062
Name:HANO, ANDREW E (DO)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:E
Last Name:HANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BEACH DR NE
Mailing Address - Street 2:#1001
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3482
Mailing Address - Country:US
Mailing Address - Phone:727-644-3904
Mailing Address - Fax:
Practice Address - Street 1:300 BEACH DR NE
Practice Address - Street 2:#1001
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3482
Practice Address - Country:US
Practice Address - Phone:727-644-3904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S4516207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067746900Medicaid
FL82537OtherBLUE CROSS / BLUE SHIELD
FL82537OtherBLUE CROSS / BLUE SHIELD
FL82537WMedicare PIN
FL82537XMedicare PIN
D60665Medicare UPIN