Provider Demographics
NPI:1629638374
Name:MUFTI, OSAMA (MD)
Entity type:Individual
Prefix:
First Name:OSAMA
Middle Name:
Last Name:MUFTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N FRANKLIN ST UNIT 1805
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3879
Mailing Address - Country:US
Mailing Address - Phone:267-602-7838
Mailing Address - Fax:
Practice Address - Street 1:27356 CASHFORD CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6935
Practice Address - Country:US
Practice Address - Phone:813-994-7000
Practice Address - Fax:813-994-3781
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-15
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME169133207W00000X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology