MEDICARE: DR. HANAA MALIK HABASHI O.D.

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	152W00000X	Optometrist	OPC3588	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1954271	OTHER		CIGNA
2	21223490855	OTHER	FL	BEECH STREET
3	2206098	OTHER	FL	UNITED HEALTHCARE
4	19702	OTHER	FL	BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619060696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANAA MALIK HABASHI O.D.

Provider Business Mailing Address
First Line	:	9560-106 CROSSHILL BOULEVARD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9560 CROSSHILL BLVD
Second Line	:	STE 106
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-5850
Country	:	US
Telephone Number	:	904-777-2927
Fax Number	:	904-777-4047

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	01/02/2018

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