Healthcare Provider Details

I. General information

NPI: 1194901249
Provider Name (Legal Business Name): MALEK HANANO MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5694 WINDHOVER DR
ORLANDO FL
32819-7935
US

IV. Provider business mailing address

5694 WINDHOVER DR
ORLANDO FL
32819-7935
US

V. Phone/Fax

Practice location:
  • Phone: 407-363-3449
  • Fax: 407-363-3450
Mailing address:
  • Phone: 407-363-3449
  • Fax: 407-363-3450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME28033
License Number StateFL

VIII. Authorized Official

Name: DR. MALEK HANANO
Title or Position: OWNER
Credential:
Phone: 321-937-5356