Basic Information
| Provider Information | |||||||||
| NPI: | 1235662974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANI | ||||||||
| FirstName: | CELINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 991 HOBSON ST | ||||||||
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| City: | LONGWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327507516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4077799726 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 W BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | OVIEDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327659260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073595693 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2017 | ||||||||
| LastUpdateDate: | 09/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 18428 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.