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General NPI Number Information
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NPI Number | 1790871317
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Entity Type | Organization
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Legal Business Name | ABBOUD FOOT & ANKLE ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 38039 ARBOR RIDGE DRIVE SUITE B
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-1347
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Country | US
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Telephone | 813-862-9664
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Fax |
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Provider Business Mailing Address
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Address Line | 38039 ARBOR RIDGE DRIVE SUITE B
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-1347
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Country | US
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Telephone | 813-862-9664
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAZEN ADIB ABBOUD
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Credential | D.P.M.
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Telephone | 813-943-3228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3233
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License Number State | FL
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