Healthcare Provider Details

I. General information

NPI: 1114176526
Provider Name (Legal Business Name): ASHRAF ABULHAIJA APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ASHRAF ABU-HAYJA

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12902 MAGNOLIA DR. MOFFITT CANCER CENTER
TAMPA FL
33612
US

IV. Provider business mailing address

12902 MAGNOLIA DR. MOFFITT CANCER CENTER
TAMPA FL
33612
US

V. Phone/Fax

Practice location:
  • Phone: 813-745-1831
  • Fax: 813-745-2645
Mailing address:
  • Phone: 813-745-1831
  • Fax: 813-745-2645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9274636
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4987215-4408
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberARNP9274636
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN9274636
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: