Healthcare Provider Details

I. General information

NPI: 1235351628
Provider Name (Legal Business Name): HAMLET R HASSAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10511 N KENDALL DR STE C201
MIAMI FL
33176-1580
US

IV. Provider business mailing address

10511 N KENDALL DR STE C201
MIAMI FL
33176-1580
US

V. Phone/Fax

Practice location:
  • Phone: 305-559-3167
  • Fax: 786-482-5707
Mailing address:
  • Phone: 305-559-3167
  • Fax: 786-482-5707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME88939
License Number StateFL

VIII. Authorized Official

Name: DR. HAMLET R HASSAN
Title or Position: PRESIDENT
Credential: MD
Phone: 954-213-3702