Individual
DR. HASSAN ALI HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
121 WHITEHALL DR, ST AUGUSTINE, FL 32086-5266
(904) 825-4500
(904) 825-3672
Mailing address
7015 A C SKINNER PKWY, SUITE 1, JACKSONVILLE, FL 32256-6932
(904) 363-2113
(904) 363-2606
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME124175
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014998800
—
FL
01
—
150UW
BC BS FL
FL
01
—
383514
AVMED
FL
Enumeration date
06/30/2009
Last updated
04/25/2022
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