Healthcare Provider Details

I. General information

NPI: 1538617089
Provider Name (Legal Business Name): TAMPA NEUROPSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2016
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 N HABANA AVE STE 203
TAMPA FL
33614-7146
US

IV. Provider business mailing address

4710 N HABANA AVE STE 203
TAMPA FL
33614-7146
US

V. Phone/Fax

Practice location:
  • Phone: 813-995-1775
  • 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 NumberME129014
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME129014
License Number StateFL

VIII. Authorized Official

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