Healthcare Provider Details
I. General information
NPI: 1710611249
Provider Name (Legal Business Name): INFECTIOUS DISEASE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17942 CACHET ISLE DR
TAMPA FL
33647-2702
US
IV. Provider business mailing address
17942 CACHET ISLE DR
TAMPA FL
33647-2702
US
V. Phone/Fax
- Phone: 727-266-0748
- Fax: 813-291-7789
- Phone: 727-266-0748
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASAD
K
MOHMAND
Title or Position: OWNER
Credential: MD
Phone: 727-266-0748