Provider Demographics
NPI:1235351628
Name:HAMLET R HASSAN MD PA
Entity Type:Organization
Organization Name:HAMLET R HASSAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMLET
Authorized Official - Middle Name:R
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-213-3702
Mailing Address - Street 1:7154 NORTH UNIVERSITY DRIVE
Mailing Address - Street 2:SUITE 323
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321
Mailing Address - Country:US
Mailing Address - Phone:954-491-9801
Mailing Address - Fax:305-225-9011
Practice Address - Street 1:2901 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE 124
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1730
Practice Address - Country:US
Practice Address - Phone:954-213-3702
Practice Address - Fax:954-473-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME889392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7226Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER