MEDICARE: DR. MARIAM CHOWDHARI MD

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	208D00000X	General Practice Physician	ME178035	FL

General Provider Information

NPI Number	:	1447710215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIAM CHOWDHARI MD

Provider Business Mailing Address
First Line	:	11707 CLUB DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-5521
Country	:	US
Telephone Number	:	813-977-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	11707 CLUB DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-5521
Country	:	US
Telephone Number	:	813-977-2222
Fax Number	:

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

Provider Enumeration Date	:	03/20/2019
Last Update Date	:	03/02/2026

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