Provider Demographics
NPI:1497435812
Name:HAMMAD, SAUSAN
Entity Type:Individual
Prefix:
First Name:SAUSAN
Middle Name:
Last Name:HAMMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 S GOLDENROD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8108
Mailing Address - Country:US
Mailing Address - Phone:407-792-1144
Mailing Address - Fax:407-232-9807
Practice Address - Street 1:690 S GOLDENROD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8108
Practice Address - Country:US
Practice Address - Phone:407-792-1144
Practice Address - Fax:407-232-9807
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027592363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily