Provider Demographics
NPI:1932105442
Name:ALHASSANI, YASIR (MD)
Entity Type:Individual
Prefix:DR
First Name:YASIR
Middle Name:
Last Name:ALHASSANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YASER
Other - Middle Name:ADIL
Other - Last Name:AL-HASSANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6171 E FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2301
Mailing Address - Country:US
Mailing Address - Phone:813-971-5012
Mailing Address - Fax:
Practice Address - Street 1:6171 E FOWLER AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617
Practice Address - Country:US
Practice Address - Phone:813-988-6569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67078207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252531301Medicaid
FL26365AMedicare PIN