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NPI Code Detail

MEDICARE: ARTHUR FORMAN MD PA

MEDICARE: ARTHUR FORMAN MD PA
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
12084P0800XPsychiatry PhysicianME21268FL

General Provider Information

NPI Number : 1780715649
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARTHUR FORMAN MD PA
Provider Business Mailing Address
First Line : 4200 NORTH ARMENIA AVE
Second Line : SUITE 4
City : TAMPA
State : FL
Zip : 33607
Country : US
Telephone Number : 813-874-8588
Fax Number : 813-876-4750
Provider Business Practice Location Address
First Line : 4200 N ARMENIA AVE
Second Line : SUITE 4
City : TAMPA
State : FL
Zip : 33607-6438
Country : US
Telephone Number : 813-874-8588
Fax Number : 813-876-4750
Authorized Official
Title or Position : PRESIDENT
Name : DR. ARTHUR JOEL FORMAN
Credential : M.D
Telephone Number : 813-874-8588
Provider Enumeration Date : 03/09/2007
Last Update Date : 10/26/2010

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