Jacksonville Pediatric Endocrinology Clinic PLLC

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

Legal business name

JACKSONVILLE PEDIATRIC ENDOCRINOLOGY CLINIC PLLC

Practice address

9191 R G Skinner Pkwy
Jacksonville, FL 32256-9655

Phone

(904) 388-3351

NPI assigned

Mar 23, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Reham Hasan, M.D.

Title

Owner

Phone

(904) 388-3351

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1114458916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13842 HARBOR CREEK PL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322246895",
            "telephone_number": "904-388-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 R G SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569655",
            "telephone_number": "904-388-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE PEDIATRIC ENDOCRINOLOGY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "HASAN",
        "authorized_official_first_name": "REHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-388-3351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Endocrinology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Endocrinology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.