Provider Demographics
NPI:1326043936
Name:OBZUT, DANA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:ANN
Last Name:OBZUT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 W DR MLK BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-321-6820
Mailing Address - Fax:813-287-6306
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-7123
Practice Address - Country:US
Practice Address - Phone:813-870-4824
Practice Address - Fax:813-554-8353
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME000002080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI39374Medicare UPIN
FL273248300Medicare PIN
FL17332ZMedicare PIN
FL17332XMedicare PIN