Healthcare Provider Details

I. General information

NPI: 1417416488
Provider Name (Legal Business Name): EMILY A. DZOBA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY HALTIGAN MD

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR
TAMPA FL
33606-3571
US

IV. Provider business mailing address

PO BOX 917770
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 813-821-8038
  • Fax:
Mailing address:
  • Phone: 813-821-8038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME155992
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME155992
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberME155992
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: