Healthcare Provider Details

I. General information

NPI: 1326985425
Provider Name (Legal Business Name): APOLLO PEDIATRIC ENDOCRINOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 W CALL ST STE B
STARKE FL
32091-3172
US

IV. Provider business mailing address

6144 SAN JOSE BLVD W
JACKSONVILLE FL
32217-2345
US

V. Phone/Fax

Practice location:
  • Phone: 832-228-0163
  • Fax: 904-580-4740
Mailing address:
  • Phone: 832-228-0163
  • Fax: 904-580-4740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: REHAM HASAN
Title or Position: OWNER
Credential: MD
Phone: 832-228-0163