Provider Demographics
NPI:1952798258
Name:HANNA, MENA (MD)
Entity Type:Individual
Prefix:
First Name:MENA
Middle Name:
Last Name:HANNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7320 E FLETCHER AVE STE 136&138
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0916
Mailing Address - Country:US
Mailing Address - Phone:813-517-0137
Mailing Address - Fax:877-396-5962
Practice Address - Street 1:7320 E FLETCHER AVE STE 136&138
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-0916
Practice Address - Country:US
Practice Address - Phone:813-517-0137
Practice Address - Fax:877-396-5962
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME134823207QH0002X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine