Provider Demographics
NPI:1134250384
Name:TAMPA BAY HAND CENTER, P.A.
Entity type:Organization
Organization Name:TAMPA BAY HAND CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHADER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUQTADIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-978-9494
Mailing Address - Street 1:13905 BRUCE B DOWNS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3998
Mailing Address - Country:US
Mailing Address - Phone:813-978-9494
Mailing Address - Fax:813-979-4817
Practice Address - Street 1:13905 BRUCE B DOWNS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3998
Practice Address - Country:US
Practice Address - Phone:813-978-9494
Practice Address - Fax:813-979-4817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL39664OtherBCBS FL GROUP ID
FL161339600OtherDEPT OF LABOR NUMBER
FL0573930001Medicare NSC
FLAQ788Medicare PIN
FLBO7151Medicare UPIN