Organization
EAST COAST HOSPITAL INPATIENT SPECIALISTS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASIB IBNE RASA M.D. (PRESIDENT)
(407) 936-0976
Entity
Organization
Contact information
Practice address
2500 W LAKE MARY BLVD, SUITE 101, LAKE MARY, FL 32746-3501
(407) 936-0976
(407) 936-0977
Mailing address
PO BOX 953457, LAKE MARY, FL 32795-3457
(407) 936-0976
(407) 936-0977
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262536900
—
FL
01
—
34130
BCBS
FL
01
—
CK4021
RAIL ROAD MEDICARE
FL
Enumeration date
01/17/2006
Last updated
03/06/2012
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