Individual
MARIAM WASSEF HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2330 UTAH AVE STE 200, EL SEGUNDO, CA 90245-4817
(281) 766-0959
Mailing address
PO BOX 100374, GAINESVILLE, FL 32610-0374
(352) 265-0291
(352) 265-0279
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME125175
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017387200
—
FL
Enumeration date
06/22/2010
Last updated
01/09/2025
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