MEDICARE: TAMPA PULMONARY AND SLEEP INSTITUTE, 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	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1538304688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA PULMONARY AND SLEEP INSTITUTE, LLC.

Provider Business Mailing Address
First Line	:	17929 HUNTING BOW CIR STE 102
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-5378
Country	:	US
Telephone Number	:	813-751-7855
Fax Number	:	813-475-5283

Provider Business Practice Location Address
First Line	:	17929 HUNTING BOW CIR STE 102
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-5378
Country	:	US
Telephone Number	:	813-751-7855
Fax Number	:	813-475-5283

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	JACK IBRAHIM HAJ OBEID
Credential	:	MD
Telephone Number	:	813-751-7855

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	10/18/2019

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