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Individual

FREDERICK EMERSON HASTY IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4300 ALTON RD, SUITE 1401, MIAMI BEACH, FL 33140-2948
(305) 674-2742
(954) 964-6084
Mailing address
PO BOX 816759, HOLLYWOOD, FL 33081-0759
(954) 964-2450
(954) 964-6084

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
112976
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005548600
FL
01
84926
FLORIDA BLUE
FL
Enumeration date
11/03/2008
Last updated
09/11/2012
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