Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 39488 | KY |
Y | 207RH0003X | Hematology & Oncology | ME101695 | FL |
NPI | 1144210022 |
---|---|
Provider Name | Mr. Osama A Hlalah |
First Address | Winter Haven, FL 33880-3053 |
Second Address | Winter Haven, FL 33880-3053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 04/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H97375 | (02) |