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Organization

ROBERT R. TAWIL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERESA LYNN JACKSON (RECEPTIONIST)
(813) 254-4262
Entity
Organization

Contact information

Practice address
3741 W NEPTUNE ST, TAMPA, FL 33629-5118
(813) 254-4262
(813) 251-6415
Mailing address
3741 W NEPTUNE ST, TAMPA, FL 33629-5118
(813) 254-4262
(813) 251-6415

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070001775
RAILROAD MEDICARE
FL
01
30919
BC/BS
FL
Enumeration date
02/11/2015
Last updated
02/11/2015
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