MEDICARE: HESHAM ALI ABDELKADER FAKHRI M.D.

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	207RI0011X	Interventional Cardiology Physician	ME107116	FL
2	207RC0000X	Cardiovascular Disease Physician	ME107116	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1225245178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HESHAM ALI ABDELKADER FAKHRI M.D.

Provider Business Mailing Address
First Line	:	301 W PLATT ST STE A428
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2292
Country	:	US
Telephone Number	:	813-708-8346
Fax Number	:	866-270-9831

Provider Business Practice Location Address
First Line	:	508 S HABANA AVE STE 160
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4190
Country	:	US
Telephone Number	:	813-708-8346
Fax Number	:	866-270-9831

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	12/28/2022

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