Provider Demographics
NPI:1396179024
Name:ALBERT TAWIL, M.D., P.A.
Entity Type:Organization
Organization Name:ALBERT TAWIL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TAWIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-876-5548
Mailing Address - Street 1:508 S HABANA AVE
Mailing Address - Street 2:STE. 360
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4181
Mailing Address - Country:US
Mailing Address - Phone:813-876-5548
Mailing Address - Fax:813-874-2477
Practice Address - Street 1:508 S HABANA AVE
Practice Address - Street 2:STE. 360
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4181
Practice Address - Country:US
Practice Address - Phone:813-876-5548
Practice Address - Fax:813-874-2477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0010834207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD53581Medicare UPIN