Healthcare Provider Details

I. General information

NPI: 1710281209
Provider Name (Legal Business Name): HANANE DAHOUI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANANE DAHOUI M.D.

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 W COLUMBIA ST
ORLANDO FL
32806
US

IV. Provider business mailing address

83 W COLUMBIA ST
ORLANDO FL
32806
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-3220
  • Fax: 321-843-3210
Mailing address:
  • Phone: 321-843-3220
  • Fax: 321-843-3210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME108082
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: