Healthcare Provider Details

I. General information

NPI: 1780831164
Provider Name (Legal Business Name): HASAN RIAZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 CORAL HILLS DR
CORAL SPRINGS FL
33065-4108
US

IV. Provider business mailing address

653-1 W 8TH ST # L18
JACKSONVILLE FL
32209-6511
US

V. Phone/Fax

Practice location:
  • Phone: 561-299-3667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME119722
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number65833
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberE-15076
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME119722
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MA11292700
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101273875
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: