Healthcare Provider Details

I. General information

NPI: 1275764169
Provider Name (Legal Business Name): JAZBEEN MAHMOOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29335 US HIGHWAY 19 N
CLEARWATER FL
33761-2146
US

IV. Provider business mailing address

3911 HARRISBURG ST NE
ST PETERSBURG FL
33703-6025
US

V. Phone/Fax

Practice location:
  • Phone: 727-739-9826
  • Fax: 877-409-4104
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME105145
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: