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NPI Code Detail

MEDICARE: DR. KAMAL MASSIS M.D.

MEDICARE: DR. KAMAL MASSIS 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
12085R0202XDiagnostic Radiology PhysicianME88837FL
22085R0204XVascular & Interventional Radiology PhysicianME 88837FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922081207
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAMAL MASSIS M.D.
Provider Business Mailing Address
First Line : 2700 UNIVERSITY SQUARE DR
Second Line : RADIOLOGY ASSOCIATES OF TAMPA
City : TAMPA
State : FL
Zip : 33612-5513
Country : US
Telephone Number : 813-251-5822
Fax Number : 813-254-4597
Provider Business Practice Location Address
First Line : 2330 UTAH AVE STE 200
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-4817
Country : US
Telephone Number : 281-766-0959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 01/23/2025

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Directions to “ DR. KAMAL MASSIS M.D.” Practice Location

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