Provider Demographics
NPI:1982914750
Name:MOHAMED I ABDELAZIZ PA
Entity Type:Organization
Organization Name:MOHAMED I ABDELAZIZ PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:IBRAHIM
Authorized Official - Last Name:ABDEL-AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-654-3200
Mailing Address - Street 1:620 EICHENFELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5973
Mailing Address - Country:US
Mailing Address - Phone:813-654-3200
Mailing Address - Fax:813-653-0232
Practice Address - Street 1:620 EICHENFELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5973
Practice Address - Country:US
Practice Address - Phone:813-654-3200
Practice Address - Fax:813-653-0232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46054207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty