Provider Demographics
NPI:1750338471
Name:INFECTIOUS DISEASES OF FLORIDA PL
Entity type:Organization
Organization Name:INFECTIOUS DISEASES OF FLORIDA PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEREEN
Authorized Official - Middle Name:ISMAIL
Authorized Official - Last Name:SABA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-596-4185
Mailing Address - Street 1:3959 VAN DYKE RD
Mailing Address - Street 2:#280
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-8025
Mailing Address - Country:US
Mailing Address - Phone:352-596-7625
Mailing Address - Fax:
Practice Address - Street 1:11008 N DALE MABRY HIGHWAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:813-340-4597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94919207RI0200X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty