Individual
MAGED MEHANNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1922 HIGHWAY 441 N, OKEECHOBEE, FL 34972-1922
(863) 763-3622
Mailing address
PO BOX 205, OKEECHOBEE, FL 34973-0205
(863) 763-3622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME0070346
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME0070346
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME0070346
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250950401
—
FL
01
—
31790
BCBS PIN#
FL
01
—
ME0070346
LICENSE
FL
Enumeration date
06/10/2006
Last updated
01/08/2010
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