Provider Demographics
NPI:1770629933
Name:TARABISHY, AHMAD B (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:B
Last Name:TARABISHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CYPRESS GLEN DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4604
Mailing Address - Country:US
Mailing Address - Phone:813-973-3333
Mailing Address - Fax:813-973-3888
Practice Address - Street 1:2400 CYPRESS GLEN DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4604
Practice Address - Country:US
Practice Address - Phone:813-973-3333
Practice Address - Fax:813-973-3888
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117051207WX0107X, 207WX0108X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207WX0108XAllopathic & Osteopathic PhysiciansOphthalmologyUveitis and Ocular Inflammatory Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009398400Medicaid
FLHM812ZMedicare UPIN