=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598941882
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSEPH HAAS MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2008
-----------------------------------------------------
Last Update Date | 02/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2454 N MCMULLEN BOOTH RD SUITE 427
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33759-1353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-723-2442
-----------------------------------------------------
Fax | 727-796-7350
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2454 N MCMULLEN BOOTH RD SUITE 427
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33759-1353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-723-2442
-----------------------------------------------------
Fax | 727-796-7350
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DR. JOSEPH E HAAS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 727-723-2442
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | ME66537
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------