Active NPI
Casey Lane Hazlewood, MD
- Anatomic Pathology & Clinical Pathology Physician
- Orlando, FL
National Provider Identifier
1124689377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 29599
- Practice address
- 52 W Underwood St
Orlando, FL 32806-1110 - Phone
- (321) 841-8933
- NPI assigned
- Jun 27, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 29599 | FL | Primary |
Addresses
Primary practice location
52 W Underwood St
Orlando, FL 32806-1110
Mailing address
820 Main Lane
Suite 1111
Orlando, FL 32801
Phone (304) 888-2622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29599 | FL | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1124689377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 MAIN LANE",
"address_2": "SUITE 1111",
"city": "ORLANDO",
"state": "FL",
"postal_code": "32801",
"telephone_number": "304-888-2622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 W UNDERWOOD ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061110",
"telephone_number": "321-841-8933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZLEWOOD",
"first_name": "CASEY",
"middle_name": "LANE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-27",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "FL",
"license": "29599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.