Provider Demographics
NPI:1427048271
Name:HASAN, SAIYID AKBAR (MD)
Entity type:Individual
Prefix:DR
First Name:SAIYID
Middle Name:AKBAR
Last Name:HASAN
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 1:11945 SAN JOSE BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-1627
Mailing Address - Country:US
Mailing Address - Phone:904-396-1725
Mailing Address - Fax:904-399-1717
Practice Address - Street 1:11512 LAKE MEAD AVE UNIT 534
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-5835
Practice Address - Country:US
Practice Address - Phone:904-564-2020
Practice Address - Fax:904-518-3297
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85728207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51475XOtherMEDICARE
FL51475OtherBLUECROSS/BLUESHIELD
FL265107600Medicaid
FL51475ZMedicare ID - Type Unspecified
FL265107600Medicaid