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NPI Code Detail

MEDICARE: DR. ISSAM I ALBANNA MD

MEDICARE:  DR. ISSAM I ALBANNA  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianME0061731FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023007135
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ISSAM I ALBANNA MD
Provider Business Mailing Address
First Line : 3288 COVE BEND DR
Second Line :
City : TAMPA
State : FL
Zip : 33613-2752
Country : US
Telephone Number : 813-979-4435
Fax Number : 813-979-4026
Provider Business Practice Location Address
First Line : 3288 COVE BEND DR
Second Line :
City : TAMPA
State : FL
Zip : 33613-2752
Country : US
Telephone Number : 813-979-4435
Fax Number : 813-979-4026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 11/03/2011

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Directions to “ DR. ISSAM I ALBANNA MD” Practice Location

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