Provider Demographics
NPI:1760943039
Name:DAWOOD, SIRAAJ
Entity Type:Individual
Prefix:
First Name:SIRAAJ
Middle Name:
Last Name:DAWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 E FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3713
Mailing Address - Country:US
Mailing Address - Phone:813-344-1084
Mailing Address - Fax:813-803-5444
Practice Address - Street 1:1903 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3713
Practice Address - Country:US
Practice Address - Phone:813-344-1084
Practice Address - Fax:813-803-5444
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME156372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine