MEDICARE: HAMLET R HASSAN MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME88939	FL

General Provider Information

NPI Number	:	1235351628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMLET R HASSAN MD PA

Provider Business Mailing Address
First Line	:	7154 NORTH UNIVERSITY DRIVE
Second Line	:	SUITE 323
City	:	TAMARAC
State	:	FL
Zip	:	33321
Country	:	US
Telephone Number	:	954-491-9801
Fax Number	:	305-225-9011

Provider Business Practice Location Address
First Line	:	2901 W CYPRESS CREEK RD
Second Line	:	SUITE 124
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1730
Country	:	US
Telephone Number	:	954-213-3702
Fax Number	:	954-473-0211

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HAMLET R HASSAN
Credential	:	MD
Telephone Number	:	954-213-3702

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	09/23/2008

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