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General NPI Number Information
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NPI Number | 1255594206
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Entity Type | Individual
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Provider Name | NOMEN AZEEM MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9360 BALM RIVERVIEW RD
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City | RIVERVIEW
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State | FL
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Zip | 33569-5104
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Country | US
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Telephone | 813-333-1353
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Fax | 813-333-2383
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Provider Business Mailing Address
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Address Line | 4700 N HABANA AVE STE 202
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City | TAMPA
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State | FL
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Zip | 33614-7150
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Country | US
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Telephone | 813-333-1353
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Fax | 813-333-1618
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME122552
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME122552
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD040855
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License Number State | DC
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