Provider Demographics
NPI:1194702852
Name:HOBBS, HASAN A (MD)
Entity type:Individual
Prefix:DR
First Name:HASAN
Middle Name:A
Last Name:HOBBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 W UNDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1110
Mailing Address - Country:US
Mailing Address - Phone:321-842-8475
Mailing Address - Fax:407-849-6470
Practice Address - Street 1:52 W UNDERWOOD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1110
Practice Address - Country:US
Practice Address - Phone:321-842-8475
Practice Address - Fax:407-849-6470
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00757992085N0700X, 2085R0202X
FLME1552812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115279400Medicaid
FL9AAFNOtherBCBS
FLPR139OtherMEDICARE PTAN OHMG
DC012312071Medicaid
MD118323100Medicaid