MEDICARE: MUHAMMAD HASSAAN IMAM MD

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	207RH0000X	Hematology (Internal Medicine) Physician	ME127609	FL
2	207RX0202X	Medical Oncology Physician	ME127609	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336466622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUHAMMAD HASSAAN IMAM MD

Provider Business Mailing Address
First Line	:	PO BOX 102222
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-2222
Country	:	US
Telephone Number	:	239-274-8200
Fax Number	:	813-976-7895

Provider Business Practice Location Address
First Line	:	460 N ORLANDO AVE
Second Line	:	STE 200 BLDG D
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2988
Country	:	US
Telephone Number	:	407-898-5452
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2010
Last Update Date	:	06/05/2026

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