Provider Demographics
NPI:1083454276
Name:AL CHAMI DE HASSOUN, LINA JANET
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:JANET
Last Name:AL CHAMI DE HASSOUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 S ORANGE AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-5471
Mailing Address - Country:US
Mailing Address - Phone:407-867-7319
Mailing Address - Fax:
Practice Address - Street 1:2875 S ORANGE AVE STE 500
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5471
Practice Address - Country:US
Practice Address - Phone:407-867-7319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22-1615246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy