| Hassanein Clinic Inc | |
|
437 Nw Prima Vista Blvd Port St Lucie FL 34983-8731 | |
| (772) 323-2461 | |
| (772) 323-2462 |
| Full Name | Hassanein Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 437 Nw Prima Vista Blvd, Port St Lucie, Florida |
| Authorized Official Name and Position | Hossam M. Hassanein (PRESIDENT) |
| Authorized Official Contact | 7723232461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hassanein Clinic Inc 437 Nw Prima Vista Blvd Port St Lucie FL 34983-8731 Ph: (772) 323-2461 | Hassanein Clinic Inc 437 Nw Prima Vista Blvd Port St Lucie FL 34983-8731 Ph: (772) 323-2461 |
| NPI Number | 1740301456 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 09/27/2007 |
| Medicare PECOS PAC ID | 4587750245 |
|---|---|
| Medicare Enrollment ID | O20071011000391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740301456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME68679 (Florida) | Primary |
| Provider Name | Hossam M Hassanein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669468864 PECOS PAC ID: 8123910650 Enrollment ID: I20040329000444 |
| Provider Name | Elizabeth N Rosainz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083985717 PECOS PAC ID: 7416113485 Enrollment ID: I20120718000731 |
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