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Organization

HANI M AGRAMA, MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HANI M AGRAMA M.D. (PRESIDENT)
(321) 631-2277
Entity
Organization

Contact information

Practice address
1257 FLORIDA AVE S, ROCKLEDGE, FL 32955-2488
(321) 631-2277
(321) 631-2279
Mailing address
1257 FLORIDA AVE S, ROCKLEDGE, FL 32955-2488
(321) 631-2277
(321) 631-2279

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
94772
BLUE SHIELD GROUP NUMBER
FL
Enumeration date
08/25/2005
Last updated
03/17/2011
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