Individual
HASANAIN AL-KHALIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME146115
FL
208M00000X
Hospitalist Physician
Primary
ME146115
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106856300
—
FL
01
—
MR202
MEDICARE HF
FL
Enumeration date
02/14/2017
Last updated
11/03/2023
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