Provider Demographics
NPI:1205156643
Name:HASSAN, ZYNAB (MD)
Entity type:Individual
Prefix:
First Name:ZYNAB
Middle Name:
Last Name:HASSAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 NE 2ND ST
Mailing Address - Street 2:SUITES 3 & 4
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2960
Mailing Address - Country:US
Mailing Address - Phone:863-467-2159
Mailing Address - Fax:863-763-0681
Practice Address - Street 1:202 NE 2ND ST
Practice Address - Street 2:SUITES 3 & 4
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2960
Practice Address - Country:US
Practice Address - Phone:863-467-2159
Practice Address - Fax:863-763-0681
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116061207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHK115ZMedicare UPIN