Provider Demographics
NPI:1679727804
Name:HANNA, CAROL ANN (DPT)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:HANNA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 SW 82ND TER APT 1034
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3243
Mailing Address - Country:US
Mailing Address - Phone:904-910-4741
Mailing Address - Fax:
Practice Address - Street 1:2900 S COMMERCE PARKWAY
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-1937
Practice Address - Country:US
Practice Address - Phone:954-217-6331
Practice Address - Fax:954-385-6289
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24358225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist