MEDICARE: DR. HISHAM HANAI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME74438	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	42446	OTHER	FL	BLUE CROSS BLUE SHIELD HO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801851332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HISHAM HANAI M.D.

Provider Business Mailing Address
First Line	:	6350 CENTRAL AVE
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33707-1430
Country	:	US
Telephone Number	:	727-381-1144
Fax Number	:	727-381-6901

Provider Business Practice Location Address
First Line	:	6350 CENTRAL AVE
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33707-1430
Country	:	US
Telephone Number	:	727-381-1144
Fax Number	:	727-381-6901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	05/05/2025

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