Individual
TAMMY C D'SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
701 UNION ST, KISSIMMEE, FL 34741-5007
(407) 518-5004
(407) 643-9343
Mailing address
701 UNION ST, KISSIMMEE, FL 34741-5007
(407) 518-5004
(407) 643-9343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OP00001702
WA
207Q00000X
Family Medicine Physician
OS13362
FL
207QA0505X
Adult Medicine Physician
Primary
OS13362
FL
Other
Enumeration date
06/04/2006
Last updated
01/29/2024
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