Provider Demographics
NPI:1295001113
Name:DAWOOD, SALLY YASSA (MD)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:YASSA
Last Name:DAWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:YASSA
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2700 HEALING WAY STE 112
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5453
Mailing Address - Country:US
Mailing Address - Phone:813-929-5330
Mailing Address - Fax:813-929-5332
Practice Address - Street 1:2700 HEALING WAY STE 112
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543
Practice Address - Country:US
Practice Address - Phone:813-929-5330
Practice Address - Fax:813-929-5332
Is Sole Proprietor?:No
Enumeration Date:2012-03-25
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122168207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine