MEDICARE: COLOWELL AMERICA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208C00000X	Colon & Rectal Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225587165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLOWELL AMERICA LLC

Provider Business Mailing Address
First Line	:	2313 W VIOLET ST STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1421
Country	:	US
Telephone Number	:	813-278-6430
Fax Number	:	855-832-3509

Provider Business Practice Location Address
First Line	:	2313 W VIOLET ST STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1421
Country	:	US
Telephone Number	:	813-278-6430
Fax Number	:	855-832-3509

Authorized Official
Title or Position	:	SURGEON/PRESIDENT
Name	:	SHIRAZ FAROOQ
Credential	:	MD
Telephone Number	:	813-278-6430

Provider Enumeration Date	:	10/03/2016
Last Update Date	:	01/03/2025

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Directions to “COLOWELL AMERICA LLC ” Practice Location

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