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General NPI Number Information
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NPI Number | 1285627380
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Entity Type | Individual
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Provider Name | HANI M AGRAMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1257 FLORIDA AVE S
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2488
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Country | US
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Telephone | 321-631-2277
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Fax | 321-631-2279
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Provider Business Mailing Address
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Address Line | 225 ANDROS AVE
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City | COCOA BEACH
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State | FL
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Zip | 32931-3311
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Country | US
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Telephone | 321-783-9557
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME23404
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License Number State | FL
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