Healthcare Provider Details

I. General information

NPI: 1700725819
Provider Name (Legal Business Name): BASIMA ALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 04/05/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13601 BRUCE B DOWNS BLVD STE 300
TAMPA FL
33613-4653
US

IV. Provider business mailing address

2120 E JOHNSON AVE STE 107
PENSACOLA FL
32514-6036
US

V. Phone/Fax

Practice location:
  • Phone: 813-615-8235
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: