Provider Demographics
NPI:1568490084
Name:HAAS, BRIAN DONALD (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:DONALD
Last Name:HAAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:415 BRIERCLIFF DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2203
Mailing Address - Country:US
Mailing Address - Phone:407-841-1490
Mailing Address - Fax:407-841-6464
Practice Address - Street 1:415 BRIERCLIFF DRIVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2203
Practice Address - Country:US
Practice Address - Phone:407-841-1490
Practice Address - Fax:407-841-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME69320207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL180027279OtherRR MEDICARE
FL037895600Medicaid
FLF71634Medicare UPIN
FL037895600Medicaid