Individual
STEPHEN E HANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7335 GLADIOLUS DR, FORT MYERS, FL 33908-5101
(239) 985-1925
(239) 321-6044
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME0046939
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048644200
—
FL
01
—
05917
BCBS OF FL
FL
01
—
205792
AVMED
FL
01
—
4237270
AETNA
FL
01
—
7198660
CIGNA
FL
01
—
P01319835
RR MEDICARE
FL
01
—
P203161
OPTIMUM
FL
01
—
P305703
FREEDOM
FL
Enumeration date
07/18/2006
Last updated
07/28/2014
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