Organization
ALPHA OMEGA MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMON HANNA DPM (PODIATRIST/FOOT AND ANKLE SURGEON)
(201) 925-1105
Entity
Organization
Contact information
Practice address
36503 US HIGHWAY 19 N, PALM HARBOR, FL 34684
(201) 925-1105
Mailing address
5750 RUSACK DR, MELBOURNE, FL 32940-8016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME131622
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3900
FL
Other
Enumeration date
06/05/2018
Last updated
06/25/2018
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