Provider Demographics
NPI:1245510791
Name:HANNA, MAHER GABER (RPH)
Entity type:Individual
Prefix:MR
First Name:MAHER
Middle Name:GABER
Last Name:HANNA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 S RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-6133
Mailing Address - Country:US
Mailing Address - Phone:386-252-4450
Mailing Address - Fax:386-255-4445
Practice Address - Street 1:1541 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-6133
Practice Address - Country:US
Practice Address - Phone:386-252-4450
Practice Address - Fax:386-252-4445
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist