Basic Information
Provider Information
NPI: 1619948429
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HANNA
FirstName: ASHRAF
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 17328
Address2:  
City: CLEARWATER
State: FL
PostalCode: 337620328
CountryCode: US
TelephoneNumber: 7277245631
FaxNumber: 7272160374
Practice Location
Address1: 2250 DREW ST
Address2:  
City: CLEARWATER
State: FL
PostalCode: 337653305
CountryCode: US
TelephoneNumber: 7277245631
FaxNumber: 7277245689
Other Information
ProviderEnumerationDate: 01/30/2006
LastUpdateDate: 07/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208VP0000XME70421FLY Allopathic & Osteopathic PhysiciansPain MedicinePain Medicine

No ID Information.


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