Wanda Banhan, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 9105668 Issued in FL

Practice address

1601 SW Archer Rd
Gainesville, FL 32608-1135

Phone

(352) 376-1611

NPI assigned

Oct 5, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1861776189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2327 WILSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330202652",
            "telephone_number": "954-801-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081135",
            "telephone_number": "352-376-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANHAN",
        "first_name": "WANDA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9105668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdulaziz Banasser, BDS
• Gary Wayne Banfield, D,D,S,
• Grant Patrick Banfill
• Bradley P Bangstad, O.D.
• Lesley Chuc Banh
• Mo'Ath Issam Abdellatif Bani Salem, M.D
• Lashauna Latia Banks-Chatman
• Gavin Banks-Hill
• Jennifer Banks
• Judith Rae Banks, M.D.

• Surgical Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.