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NPI Code Detail

MEDICARE: DR. LYDIA MUSHONGA M.D.

MEDICARE: DR. LYDIA MUSHONGA 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
1207V00000XObstetrics & Gynecology Physician4301088377MI
2174400000XSpecialist1795991MI
3207V00000XObstetrics & Gynecology PhysicianME151949FL

Other Identifiers

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

General Provider Information

NPI Number : 1992921894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYDIA MUSHONGA M.D.
Provider Business Mailing Address
First Line : PO BOX 25317
Second Line :
City : TAMPA
State : FL
Zip : 33622-5317
Country : US
Telephone Number : 813-286-0033
Fax Number : 813-282-1806
Provider Business Practice Location Address
First Line : 5002 W LEMON ST
Second Line :
City : TAMPA
State : FL
Zip : 33609-1104
Country : US
Telephone Number : 813-286-0033
Fax Number : 813-282-1806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 01/08/2026

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