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1336521830

NPI Code Detail

MEDICARE: HADI MAHMALJY M.D

MEDICARE: HADI MAHMALJY M.D

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	207R00000X	Internal Medicine Physician	69916	CT
2	207R00000X	Internal Medicine Physician	125067688	IL
3	207R00000X	Internal Medicine Physician	153884	FL
4	207RC0000X	Cardiovascular Disease Physician	153884	FL
5	390200000X	Student in an Organized Health Care Education/Training Program		CT
6	207RI0011X	Interventional Cardiology Physician	153884	FL

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	:	1336521830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HADI MAHMALJY M.D

Provider Business Mailing Address
First Line	:	3010 E 138TH AVE STE 12
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-3999
Country	:	US
Telephone Number	:	813-975-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 E 138TH AVE STE 12
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-3999
Country	:	US
Telephone Number	:	813-975-2800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	08/24/2022

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Directions to “ HADI MAHMALJY M.D” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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