Provider Demographics
NPI:1700508751
Name:GERGES, HANY N (RPH)
Entity type:Individual
Prefix:
First Name:HANY
Middle Name:N
Last Name:GERGES
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 1:5536 GREYSTON ST
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-1136
Mailing Address - Country:US
Mailing Address - Phone:727-265-0420
Mailing Address - Fax:
Practice Address - Street 1:5536 GREYSTON ST
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-1136
Practice Address - Country:US
Practice Address - Phone:727-265-0420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist