Provider Demographics
NPI:1770508061
Name:HAAS, JOSEPH E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:HAAS
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 1:2454 N MCMULLEN BOOTH RD
Mailing Address - Street 2:SUITE 427
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1353
Mailing Address - Country:US
Mailing Address - Phone:727-723-2442
Mailing Address - Fax:727-796-7350
Practice Address - Street 1:2454 N MCMULLEN BOOTH RD
Practice Address - Street 2:SUITE 427
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1353
Practice Address - Country:US
Practice Address - Phone:727-723-2442
Practice Address - Fax:727-796-7350
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66537174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL593657018OtherTAX ID NUMBER
FLF19694Medicare UPIN
FL26981Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER