Provider Demographics
NPI:1154418572
Name:ZEYA, HASAN ISMAIL (MD)
Entity type:Individual
Prefix:DR
First Name:HASAN
Middle Name:ISMAIL
Last Name:ZEYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13746 CHESTERSALL DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2501
Mailing Address - Country:US
Mailing Address - Phone:813-486-3611
Mailing Address - Fax:813-264-6349
Practice Address - Street 1:4543 S MANHATTAN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-2330
Practice Address - Country:US
Practice Address - Phone:813-831-8888
Practice Address - Fax:813-831-6292
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 039421207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD20720Medicare UPIN
FL02209Medicare ID - Type Unspecified