Basic Information
| Provider Information | |||||||||
| NPI: | 1962461731 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAKKI | ||||||||
| FirstName: | A-HAMID | ||||||||
| MiddleName: | I. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 455 PINELLAS ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337563354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274451992 | ||||||||
| FaxNumber: | 7274451993 | ||||||||
| Practice Location | |||||||||
| Address1: | 1840 MEASE DR | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | SAFETY HARBOR | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346956602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7277256246 | ||||||||
| FaxNumber: | 7277265865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2006 | ||||||||
| LastUpdateDate: | 10/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | ME50357 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 047848200 | 05 | FL | MEDICAID |