Provider Demographics
NPI:1851900625
Name:WALID AZIZ MD PA
Entity Type:Organization
Organization Name:WALID AZIZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALID
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-373-6601
Mailing Address - Street 1:3204 BLUFFS DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2719
Mailing Address - Country:US
Mailing Address - Phone:219-671-0447
Mailing Address - Fax:
Practice Address - Street 1:1555 S FORT HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2004
Practice Address - Country:US
Practice Address - Phone:727-373-6601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty