Provider Demographics
NPI:1447403746
Name:PATHAN, ASIM HASAN (MBBS)
Entity Type:Individual
Prefix:DR
First Name:ASIM
Middle Name:HASAN
Last Name:PATHAN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 SIMMONS LOOP FL 4
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-9498
Mailing Address - Country:US
Mailing Address - Phone:813-302-8388
Mailing Address - Fax:813-302-8453
Practice Address - Street 1:6901 SIMMONS LOOP
Practice Address - Street 2:4TH FLOOR
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-9498
Practice Address - Country:US
Practice Address - Phone:813-302-8388
Practice Address - Fax:813-302-8453
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125055226207R00000X
FLME122066207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine