Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 4301094481 | MI |
Y | 207RC0200X | Critical Care Medicine | ME127525 | FL |
NPI | 1033344627 |
---|---|
Provider Name | Dr. Azzat A Ali |
First Address | Temple Terrace, FL 33637-0926 |
Second Address | Temple Terrace, FL 33637-0926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2009 |
Last Update Date | 10/10/2021 |