Healthcare Provider Details

I. General information

NPI: 1750037867
Provider Name (Legal Business Name): GEORGE HANNA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2049 WELBILT BLVD
TRINITY FL
34655-4700
US

IV. Provider business mailing address

2049 WELBILT BLVD
TRINITY FL
34655-4700
US

V. Phone/Fax

Practice location:
  • Phone: 727-940-3521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS40421
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: