Provider Demographics
NPI:1619520533
Name:VANHASSEL, MARISSA ANNE
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:ANNE
Last Name:VANHASSEL
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 1:4107 USF CEDAR CIRCLE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33620-0001
Mailing Address - Country:US
Mailing Address - Phone:404-482-4013
Mailing Address - Fax:
Practice Address - Street 1:4107 USF CEDAR CIRCLE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33620-8900
Practice Address - Country:US
Practice Address - Phone:813-974-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program