Active NPI
Mary Jo Hasan, MED CCC/SLP
- Speech-Language Pathologist
- Brandon, FL
National Provider Identifier
1174893093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 2713
- Practice address
- 1465 Oakfield Dr
Brandon, FL 33511-4854 - Phone
- (813) 655-0404
- NPI assigned
- Jan 10, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA 2713 | FL | Primary |
Addresses
Primary practice location
1465 Oakfield Dr
Brandon, FL 33511-4854
Mailing address
18137 Longwater Run Dr
Tampa, FL 33647-2212
Phone (813) 751-7524
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
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 2713 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1174893093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18137 LONGWATER RUN DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336472212",
"telephone_number": "813-751-7524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 OAKFIELD DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335114854",
"telephone_number": "813-655-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASAN",
"first_name": "MARY",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "MED CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-10",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 2713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.