Healthcare Provider Details

I. General information

NPI: 1922016351
Provider Name (Legal Business Name): HASSAN FARHAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17021 US HIGHWAY 441
MOUNT DORA FL
32757-6734
US

IV. Provider business mailing address

PO BOX 100186
GAINESVILLE FL
32610-0186
US

V. Phone/Fax

Practice location:
  • Phone: 352-720-7999
  • Fax:
Mailing address:
  • Phone: 352-265-5911
  • Fax: 352-265-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberC10006007
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberD42603
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME82249
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME82249
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: