Provider Demographics
NPI:1326128323
Name:HASSAN, HAMLET (MD)
Entity Type:Individual
Prefix:MR
First Name:HAMLET
Middle Name:
Last Name:HASSAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7154 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 323
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2916
Mailing Address - Country:US
Mailing Address - Phone:954-213-3702
Mailing Address - Fax:954-473-0211
Practice Address - Street 1:3611 SW 107TH AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3636
Practice Address - Country:US
Practice Address - Phone:305-594-4421
Practice Address - Fax:305-594-4644
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-889392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL48099OtherBC/BS
FL270371800Medicaid
FL48099OtherBC/BS
FL270371800Medicaid