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1770556508

NPI Code Detail

MEDICARE: DR. MOSTAFA S HASSAN MD

MEDICARE: DR. MOSTAFA S HASSAN 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	2080N0001X	Neonatal-Perinatal Medicine Physician	213543	NY
2	2080N0001X	Neonatal-Perinatal Medicine Physician	ME119222	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770556508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOSTAFA S HASSAN MD

Provider Business Mailing Address
First Line	:	PO BOX 191
Second Line	:	PROVIDER ENROLLMENT DEPARTMENT
City	:	ROCKLAND
State	:	DE
Zip	:	19732-0191
Country	:	US
Telephone Number	:	302-651-6212
Fax Number	:	302-651-4945

Provider Business Practice Location Address
First Line	:	13535 NEMOURS PKWY
Second Line	:	NEMOURS CHILDRENS HOSPITAL
City	:	ORLANDO
State	:	FL
Zip	:	32827-7402
Country	:	US
Telephone Number	:	407-567-4760
Fax Number	:	407-567-3127

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	03/13/2017

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Directions to “ DR. MOSTAFA S HASSAN MD” Practice Location

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