Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 35.086907 | OH |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 4301097735 | MI |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD2013-0056 | NM |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME102306 | FL |
N | 208G00000X | Cardiothoracic Vascular Surgeon | R8008 | TX |
NPI | 1083877682 |
---|---|
Provider Name | Dr. Mohammed Hassan |
First Address | Lakeland, FL 33805 |
Second Address | Lakeland, FL 33805-4543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 09/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083877682 | (05) | MI |