Provider Demographics
NPI:1225587165
Name:COLOWELL AMERICA LLC
Entity Type:Organization
Organization Name:COLOWELL AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:FAROOQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-515-6905
Mailing Address - Street 1:PO BOX 4386
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33677-4386
Mailing Address - Country:US
Mailing Address - Phone:888-275-6880
Mailing Address - Fax:888-275-0059
Practice Address - Street 1:4809 N ARMENIA AVE
Practice Address - Street 2:STE 230
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603
Practice Address - Country:US
Practice Address - Phone:813-515-6905
Practice Address - Fax:813-515-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty