Provider Demographics
NPI:1568811594
Name:KASEB, HATEM OSAMA (MD,PHD, MPH)
Entity Type:Individual
Prefix:
First Name:HATEM
Middle Name:OSAMA
Last Name:KASEB
Suffix:
Gender:M
Credentials:MD,PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 741087
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1087
Mailing Address - Country:US
Mailing Address - Phone:689-216-8150
Mailing Address - Fax:689-216-8931
Practice Address - Street 1:6700 LAKE NONA BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7729
Practice Address - Country:US
Practice Address - Phone:689-216-8150
Practice Address - Fax:689-216-8931
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME158666207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology