Provider Demographics
NPI:1124086699
Name:HASSELBRING, CARYN G (MD)
Entity type:Individual
Prefix:DR
First Name:CARYN
Middle Name:G
Last Name:HASSELBRING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3160 SOUTHGATE COMMERCE BLVD
Mailing Address - Street 2:STE 30
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-8549
Mailing Address - Country:US
Mailing Address - Phone:407-859-4540
Mailing Address - Fax:407-859-3815
Practice Address - Street 1:3160 SOUTHGATE COMMERCE BLVD
Practice Address - Street 2:STE 30
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-8549
Practice Address - Country:US
Practice Address - Phone:407-859-4540
Practice Address - Fax:407-859-3815
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051093207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046298500Medicaid
FL04292ZMedicare ID - Type UnspecifiedPROVIDER #
FL046298500Medicaid