MEDICARE: SYED 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	207R00000X	Internal Medicine Physician	ME71461	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME71461	OTHER	FL	STATE LICENSE

General Provider Information

NPI Number	:	1467870451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYED HASSAN MD PA

Provider Business Mailing Address
First Line	:	3005 CARING WAY
Second Line	:	UNITS 2 AND 3
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-5304
Country	:	US
Telephone Number	:	941-249-8493
Fax Number	:	941-249-8537

Provider Business Practice Location Address
First Line	:	3005 CARING WAY
Second Line	:	UNITS 2 AND 3
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-5304
Country	:	US
Telephone Number	:	941-249-8493
Fax Number	:	941-249-8537

Authorized Official
Title or Position	:	MD OWNER
Name	:	SYED HASSAN
Credential	:	MD
Telephone Number	:	941-249-8493

Provider Enumeration Date	:	04/07/2014
Last Update Date	:	08/19/2014

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Directions to “SYED HASSAN MD PA ” Practice Location

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