Provider Demographics
NPI:1801434774
Name:ALLAITHY, AZIZ
Entity type:Individual
Prefix:
First Name:AZIZ
Middle Name:
Last Name:ALLAITHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13235 SANCTUARY COVE DR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-2192
Mailing Address - Country:US
Mailing Address - Phone:813-215-8490
Mailing Address - Fax:
Practice Address - Street 1:13235 SANCTUARY COVE DR UNIT 104
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-2192
Practice Address - Country:US
Practice Address - Phone:813-215-8490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst