MEDICARE: MARK AZMY 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
1	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	ME163310	FL

General Provider Information

NPI Number	:	1134758824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK AZMY MD

Provider Business Mailing Address
First Line	:	3001 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6307
Country	:	US
Telephone Number	:	813-586-5685
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6307
Country	:	US
Telephone Number	:	813-586-5685
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2020
Last Update Date	:	06/16/2026

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