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NPI Code Detail

MEDICARE: AMR HASSAN D.D.S.

MEDICARE:   AMR  HASSAN  D.D.S.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2122300000XDentistDN 21829FL

General Provider Information

NPI Number : 1801214762
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMR HASSAN D.D.S.
Provider Business Mailing Address
First Line : 13584 UNIVERSITY PLAZA ST
Second Line :
City : TAMPA
State : FL
Zip : 33613-4628
Country : US
Telephone Number : 813-971-8141
Fax Number :
Provider Business Practice Location Address
First Line : 13584 UNIVERSITY PLAZA ST
Second Line :
City : TAMPA
State : FL
Zip : 33613-4628
Country : US
Telephone Number : 813-971-8141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2014
Last Update Date : 07/05/2016

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Directions to “ AMR HASSAN D.D.S.” Practice Location

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