Healthcare Provider Details

I. General information

NPI: 1205396710
Provider Name (Legal Business Name): IRENE MURATIDES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 S MACDILL AVE
TAMPA FL
33611-1514
US

IV. Provider business mailing address

3705 S MACDILL AVE
TAMPA FL
33611-1514
US

V. Phone/Fax

Practice location:
  • Phone: 813-730-4924
  • Fax: 813-544-2701
Mailing address:
  • Phone: 813-957-5503
  • Fax: 813-544-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS18282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: