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Individual
DR. HASSAN TAVAKKOLI
Active
Individual
DR. HASSAN TAVAKKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OS 6626
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0853300
AETNA
FL
01
—
235914
AVMED
FL
01
—
375397200
MEDICAID
FL
05
—
375397200
—
FL
01
—
650505235
UNITEDHEALTHCARE
FL
01
—
80799
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/27/2007
Last updated
03/23/2021
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