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General NPI Number Information
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NPI Number | 1770566531
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Entity Type | Individual
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Provider Name | MAZEN KATTIH M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/25/2005
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 116 PARSONS PARK DR
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City | BRANDON
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State | FL
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Zip | 33511-6066
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Country | US
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Telephone | 813-571-0500
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Fax | 813-571-0512
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Provider Business Mailing Address
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Address Line | PO BOX 291489
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City | TAMPA
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State | FL
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Zip | 33687-1489
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Country | US
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Telephone | 813-571-0500
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Fax | 813-571-0512
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME79267
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License Number State | FL
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