Individual
MR. IMTIAZ HAROON MEMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6000 49TH ST N, ST. PETERSBURG, ST PETERSBURG, FL 33709-2114
(727) 521-5510
Mailing address
1209 CANYON OAKS DR, BRANDON, FL 33510-2173
(561) 798-3164
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106741
FL
Other
Enumeration date
10/03/2012
Last updated
09/02/2014
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