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General NPI Number Information
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NPI Number | 1275764169
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Entity Type | Individual
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Provider Name | JAZBEEN MAHMOOD M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 6245 66TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-5025
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Country | US
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Telephone | 727-873-3891
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Fax |
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Provider Business Mailing Address
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Address Line | 3911 HARRISBURG ST NE
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City | ST PETERSBURG
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State | FL
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Zip | 33703-6025
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME105145
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License Number State | FL
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