Healthcare Provider Details

I. General information

NPI: 1972356483
Provider Name (Legal Business Name): ASHKAAR QAZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21808 STATE ROAD 54
LUTZ FL
33549-6923
US

IV. Provider business mailing address

21808 STATE ROAD 54
LUTZ FL
33549-6923
US

V. Phone/Fax

Practice location:
  • Phone: 813-922-8621
  • Fax: 845-333-7342
Mailing address:
  • Phone: 813-922-8621
  • Fax: 845-333-7342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: