Provider Demographics
NPI:1952327942
Name:HASSAN, SHAWKY A (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWKY
Middle Name:A
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 1:680 2ND AVE N STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5758
Mailing Address - Country:US
Mailing Address - Phone:239-261-5599
Mailing Address - Fax:239-261-6643
Practice Address - Street 1:680 2ND AVE N STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5758
Practice Address - Country:US
Practice Address - Phone:239-261-5599
Practice Address - Fax:239-261-6643
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME23624207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11133OtherGRP K1343
FL11133OtherGRP K1343
11133ZMedicare ID - Type Unspecified