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Individual

DR. HANI M AGRAMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1257 FLORIDA AVE S, ROCKLEDGE, FL 32955-2488
(321) 631-2277
(321) 631-2279
Mailing address
225 ANDROS AVE, COCOA BEACH, FL 32931-3311
(321) 783-9557

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME23404
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
050665600
FL
01
05290
BLUE SHIELD
FL
01
4133237
AETNA PROVIDER NUMBER
01
ME23404
MEDICAL LICENSE NUMBER
FL
Enumeration date
08/24/2005
Last updated
03/07/2023
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