Provider Demographics
NPI:1619060696
Name:HABASHI, HANAA MALIK (OD)
Entity Type:Individual
Prefix:DR
First Name:HANAA
Middle Name:MALIK
Last Name:HABASHI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9560-106 CROSSHILL BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9560 CROSSHILL BLVD
Practice Address - Street 2:STE 106
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222-5850
Practice Address - Country:US
Practice Address - Phone:904-777-2927
Practice Address - Fax:904-777-4047
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3588152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1954271OtherCIGNA
FL21223490855OtherBEECH STREET
FL2206098OtherUNITED HEALTHCARE
FL19702OtherBLUE CROSS BLUE SHIELD
1954271OtherCIGNA
FL21223490855OtherBEECH STREET