Provider Demographics
NPI:1730174632
Name:BATAYNEH, HASSAN N (MD)
Entity type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:N
Last Name:BATAYNEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 N UNIVERSITY DR
Mailing Address - Street 2:STE 102
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2908
Mailing Address - Country:US
Mailing Address - Phone:954-718-9777
Mailing Address - Fax:954-718-0233
Practice Address - Street 1:7225 N UNIVERSITY DR
Practice Address - Street 2:STE 102
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2908
Practice Address - Country:US
Practice Address - Phone:954-718-9777
Practice Address - Fax:954-718-0233
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1199592084N0400X, 2084N0600X, 2084S0012X, 2084S0012X, 2084N0400X
NC2012-013092084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012903100Medicaid
FLME119959OtherMEDICAL LICENSE
FLHX202XMedicare PIN
FLHX202ZMedicare PIN
FLHX202YMedicare PIN
ARBA7414535OtherDEA
ARE4131Medicare ID - Type UnspecifiedLICENSE
AZ236705-01Medicaid
AR7724022OtherAETNA
FLHX202XMedicare PIN
AZ1730174632OtherBCBS
AZPZ00433498OtherRAIL ROAD MEDICARE
AR155575001Medicaid
FLHX202YMedicare PIN
MO207252305Medicaid