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General NPI Number Information
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NPI Number | 1114197126
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Entity Type | Organization
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Legal Business Name | ADVANCED PEDIATRIC OPHTHALMOLOGY AND ADULT STRABISMUS
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 12220 BRUCE B DOWNS BLVD
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City | TAMPA
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State | FL
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Zip | 33612-9201
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Country | US
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Telephone | 813-910-5240
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Fax | 813-631-5046
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Provider Business Mailing Address
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Address Line | 12220 BRUCE B DOWNS BLVD
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City | TAMPA
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State | FL
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Zip | 33612-9201
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Country | US
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Telephone | 813-910-5240
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Fax | 813-631-5046
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | DR. MAGDA BARSOUM-HOMSY
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Credential | M.D.
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Telephone | 813-910-5240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME72301
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License Number State | FL
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