MEDICARE: FLORIDA PRIMARY CARE PARTNERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1548866858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA PRIMARY CARE PARTNERS LLC

Provider Business Mailing Address
First Line	:	8080 PASADENA BLVD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-3537
Country	:	US
Telephone Number	:	954-951-0990
Fax Number	:	954-900-9221

Provider Business Practice Location Address
First Line	:	8080 PASADENA BLVD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-3537
Country	:	US
Telephone Number	:	954-951-0990
Fax Number	:	954-900-9221

Authorized Official
Title or Position	:	CEO
Name	:	MIAN HASAN
Credential	:	MD
Telephone Number	:	954-951-0990

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	10/19/2023

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