Provider Demographics
NPI:1629161534
Name:SYED, FATHIMAZZOHARE (MD)
Entity Type:Individual
Prefix:MS
First Name:FATHIMAZZOHARE
Middle Name:
Last Name:SYED
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 1:3661 MADACA LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2048
Mailing Address - Country:US
Mailing Address - Phone:813-968-7830
Mailing Address - Fax:813-265-9697
Practice Address - Street 1:3606 MADACA LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2057
Practice Address - Country:US
Practice Address - Phone:813-968-7830
Practice Address - Fax:813-265-9697
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107716207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine