MEDICARE: DR. SYED K HASSAN M.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	207R00000X	Internal Medicine Physician	ME0071461	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	32408	OTHER	FL	BCBS
3	292260	OTHER	FL	WELLCARE
4	5291720	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1881687507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYED K HASSAN M.D.

Provider Business Mailing Address
First Line	:	3005 CARING WAY
Second Line	:	UNITS 2 NS 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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2005
Last Update Date	:	09/22/2014

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