Provider Demographics
NPI:1841674546
Name:HANNA, MAREENA (DO)
Entity type:Individual
Prefix:DR
First Name:MAREENA
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 W BAY DR STE 202
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2276
Mailing Address - Country:US
Mailing Address - Phone:727-559-0895
Mailing Address - Fax:727-518-7633
Practice Address - Street 1:1345 W BAY DR STE 202
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2276
Practice Address - Country:US
Practice Address - Phone:727-559-0895
Practice Address - Fax:727-518-7633
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14493207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine