Provider Demographics
NPI:1164691515
Name:MINA OZA M.D., P.A.
Entity Type:Organization
Organization Name:MINA OZA M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-932-3993
Mailing Address - Street 1:3104 W WATERS AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2800
Mailing Address - Country:US
Mailing Address - Phone:813-932-3993
Mailing Address - Fax:813-932-0612
Practice Address - Street 1:3104 W WATERS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2800
Practice Address - Country:US
Practice Address - Phone:813-932-3993
Practice Address - Fax:813-932-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00554642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0396Medicare UPIN