Provider Demographics
NPI:1710935879
Name:HASSAN, SYED ARSHAD (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:ARSHAD
Last Name:HASSAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 CLARK ST
Mailing Address - Street 2:STE 1010
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9270
Mailing Address - Country:US
Mailing Address - Phone:407-359-5098
Mailing Address - Fax:407-365-5119
Practice Address - Street 1:870 CLARK ST
Practice Address - Street 2:STE 1010
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9270
Practice Address - Country:US
Practice Address - Phone:407-359-5098
Practice Address - Fax:407-365-5119
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 73203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262537700Medicaid
FL42357YMedicare PIN
FL262537700Medicaid