Provider Demographics
NPI:1801822457
Name:HASEN, KENT V (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:V
Last Name:HASEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3699 AIRPORT PULLING RD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-8516
Mailing Address - Country:US
Mailing Address - Phone:239-262-5662
Mailing Address - Fax:239-244-8278
Practice Address - Street 1:3699 AIRPORT PULLING RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8516
Practice Address - Country:US
Practice Address - Phone:239-262-5662
Practice Address - Fax:239-244-8278
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2016-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 84935208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH68050Medicare UPIN
FL51387Medicare ID - Type Unspecified