Healthcare Provider Details

I. General information

NPI: 1417027665
Provider Name (Legal Business Name): KI M HASSLER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 JACARANDA BLVD
VENICE FL
34292
US

IV. Provider business mailing address

1215 JACARANDA BLVD
VENICE FL
34292-4520
US

V. Phone/Fax

Practice location:
  • Phone: 941-451-8282
  • Fax: 941-451-8434
Mailing address:
  • Phone: 941-451-8282
  • Fax: 941-451-8434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOS025384C
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036176342
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOS8522
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number13148-321
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: