Healthcare Provider Details

I. General information

NPI: 1376713727
Provider Name (Legal Business Name): NURUDDIN JOOMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2008
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PINELLAS ST SUITE 300
CLEARWATER FL
33756-3312
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 727-447-8100
  • Fax: 727-461-2603
Mailing address:
  • Phone: 239-274-8200
  • Fax: 239-278-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME101795
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME101795
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: