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Individual

SHIRIN HASAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1717 S ORANGE AVE STE 100, ORLANDO, FL 32806-2946
(407) 650-7715
(407) 650-7124
Mailing address
PO BOX 191, PROVIDER ENROLLMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME64918
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
257280000
FL
01
25882
BCBS
FL
Enumeration date
01/10/2007
Last updated
10/20/2011
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