Healthcare Provider Details

I. General information

NPI: 1386750818
Provider Name (Legal Business Name): JAFFREY HASHIMIE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9309 DEER CREEK DR
TAMPA FL
33647-2287
US

IV. Provider business mailing address

9309 DEER CREEK DR
TAMPA FL
33647-2287
US

V. Phone/Fax

Practice location:
  • Phone: 813-631-7124
  • Fax:
Mailing address:
  • Phone: 813-631-7124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberME78941
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: