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General NPI Number Information
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NPI Number | 1891254512
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Entity Type | Organization
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Legal Business Name | BAY AREA RETINA SPECIALISTS LLC
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 4178 N ARMENIA AVE
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City | TAMPA
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State | FL
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Zip | 33607-6429
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Country | US
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Telephone | 813-999-3998
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Fax | 813-522-3371
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Provider Business Mailing Address
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Address Line | 4178 N ARMENIA AVE
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City | TAMPA
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State | FL
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Zip | 33607-6429
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Country | US
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Telephone | 813-999-3998
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Fax | 813-522-3371
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Authorized Official
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Title or Position | DOCTOR PROVIDER/OWNER
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Name | DR. FAYSSAL EL-JABALI
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Credential | DO
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Telephone | 813-999-3998
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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 |
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License Number State |
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