Mutasim N. Abu-Hasan, MD

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

ME107986 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 273-8379

Fax

(352) 392-4450

NPI assigned

Sep 16, 2005

Last updated

Feb 8, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1558356402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-273-8379",
            "fax_number": "352-392-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-8379",
            "fax_number": "352-392-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABU-HASAN",
        "first_name": "MUTASIM",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "IA",
            "license": "33418",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "IA",
            "license": "33418",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "KS",
            "license": "04-33202",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "ME107986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002981400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0212985",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "17554",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Absolute Health Center, Inc.
• Abt Wellness and Retreats LLC
• Sarah H Abu Arqub, BDS, MSC
• Mohammad Ghazi a.F. Abu-Farsakh, M.D.
• Amer A. Abu-Hanna, D.D.S., M.S.
• Dania Abu-Jubara, DO
• Reem Sameer Abu-Rustum, MD
• Husam Abualnadi
• Sewar Hisham Abuarqob
• Khaled Yousef Mohammad Abubaker, M.D

• Pediatric Pulmonology Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Pediatric Pulmonology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.