Healthcare Provider Details

I. General information

NPI: 1093372724
Provider Name (Legal Business Name): SAMIRA YUKSEL HASSAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9541 MOSS PRESERVE PKWY
ORLANDO FL
32832-6769
US

IV. Provider business mailing address

26 N 6TH ST APT 471
ALLENTOWN PA
18101-1438
US

V. Phone/Fax

Practice location:
  • Phone: 407-478-6249
  • Fax: 407-478-6250
Mailing address:
  • Phone: 941-704-3393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT217874
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: