Provider Demographics
NPI:1881975019
Name:ELLIOT E. CAZES MD, NEW TAMPA OB-GYN, PA
Entity type:Organization
Organization Name:ELLIOT E. CAZES MD, NEW TAMPA OB-GYN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAZES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-977-2757
Mailing Address - Street 1:14424 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613
Mailing Address - Country:US
Mailing Address - Phone:813-977-2757
Mailing Address - Fax:813-977-6639
Practice Address - Street 1:14424 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2612
Practice Address - Country:US
Practice Address - Phone:813-977-2757
Practice Address - Fax:813-977-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 67876174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26834ROtherMEDICARE ID TYPE UNSPECIFIED
FL377511900Medicaid
FL377511900Medicaid