Healthcare Provider Details

I. General information

NPI: 1205564366
Provider Name (Legal Business Name): TAMPA NEUROPSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

625 6TH AVE S STE 155
ST PETERSBURG FL
33701-4619
US

IV. Provider business mailing address

603 S BOULEVARD
TAMPA FL
33606-2629
US

V. Phone/Fax

Practice location:
  • Phone: 727-440-5513
  • Fax: 813-642-4877
Mailing address:
  • Phone: 813-995-1775
  • Fax: 813-642-4877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: FAIZI AHMED
Title or Position: OWNER
Credential: MD
Phone: 267-247-1580