Individual ProviderHassan GhozInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4500 San Pablo Rd S, Jacksonville, FL 32224(904) 953-2000PECOS EnrollmentBased on the most recent information from CMS, provider Hassan Ghoz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1497136840Provider TypeIndividualFull NameGhoz, HassanCredentialMBBCHGenderMaleSole ProprietorNoEnumeration Date6/11/2015Last Updated8/31/2020Contact InformationPractice LocationPractice Address4500 San Pablo Rd S, Jacksonville, FL 32224Phone(904) 953-2000FaxUnlisted FaxMailing LocationMailing Address4500 San Pablo Rd S, Jacksonville, FL 32224-1865Phone(904) 953-2000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RG0100XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseME135075FloridaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense263381Massachusetts