Individual provider Active NPI

Ghassan Dhannoon

  • Driver
  • Casselberry, FL
National Provider Identifier
1720619075
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
D550297593420 Issued in FL
Practice address
1151 Laura St # 11
Casselberry, FL 32707-2508
Phone
(407) 529-4367
NPI assigned
Jan 27, 2020
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X D550297593420 FL Primary

Addresses

Primary practice location

1151 Laura St # 11
Casselberry, FL 32707-2508

Mailing address

1151 Laura St # 11
Casselberry, FL 32707-2508

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

State licenses

LicenseStateTypeSpecialty
D550297593420FLMDDriver

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1720619075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 LAURA ST # 11",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327072508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 LAURA ST # 11",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327072508",
            "telephone_number": "407-529-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANNOON",
        "first_name": "GHASSAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "FL",
            "license": "D550297593420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselberry, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.