Basic Information
| Provider Information | |||||||||
| NPI: | 1538149422 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMADEH | ||||||||
| FirstName: | MAZEN | ||||||||
| MiddleName: | B. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3090 CARUSO CT STE 50 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328068510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4074817179 | ||||||||
| FaxNumber: | 4074817190 | ||||||||
| Practice Location | |||||||||
| Address1: | 9400 TURKEY LAKE RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328198001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3218435500 | ||||||||
| FaxNumber: | 3218435550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 10/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME71725 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | ME71725 | FL | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 32995 | 01 | FL | BCBS | OTHER | IE801S | 01 | FL | MEDICARE HF | OTHER | 014758100 | 05 | FL | MEDICAID |