Provider Demographics
NPI:1104909480
Name:FLOWERS, HASSAN EMANUEL (PA-C)
Entity type:Individual
Prefix:MR
First Name:HASSAN
Middle Name:EMANUEL
Last Name:FLOWERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:HERMAN
Other - Middle Name:EMANUEL
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1162 CYPRESS GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7560
Mailing Address - Country:US
Mailing Address - Phone:407-343-9006
Mailing Address - Fax:407-343-0999
Practice Address - Street 1:720 W OAK ST
Practice Address - Street 2:SUITE 101
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4989
Practice Address - Country:US
Practice Address - Phone:407-343-7799
Practice Address - Fax:407-343-0099
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9103841363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical