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General NPI Number Information
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NPI Number | 1043602584
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Entity Type | Organization
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Legal Business Name | SHEREZA N. ABDOOL D.O. P.C.
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 02/20/2015
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Provider Practice Location Address
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Address Line | 1501 S PINELLAS AVE SUITE P
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-1955
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Country | US
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Telephone | 727-940-5278
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Fax | 813-464-3113
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Provider Business Mailing Address
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Address Line | 1501 S PINELLAS AVE SUITE P
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-1955
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Country | US
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Telephone | 727-940-5278
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Fax | 813-464-3113
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Authorized Official
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Title or Position | OWNER
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Name | SHEREZA ABDOOL
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Credential | D.O.
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Telephone | 646-752-4203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 11562
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License Number State | FL
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