MEDICARE: DR. FAYSSAL EL-JABALI D.O.

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	207WX0107X	Retina Specialist (Ophthalmology) Physician	OS13896	FL
2	207W00000X	Ophthalmology Physician	OS13896	FL

General Provider Information

NPI Number	:	1629199096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAYSSAL EL-JABALI D.O.

Provider Business Mailing Address
First Line	:	4178 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6429
Country	:	US
Telephone Number	:	813-999-3998
Fax Number	:	813-522-3371

Provider Business Practice Location Address
First Line	:	4178 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6429
Country	:	US
Telephone Number	:	813-999-3998
Fax Number	:	813-522-3371

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/29/2024

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