Organization
MINIMALLY INVASIVE SURGICAL AFFILIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TALAL HAMDAN MD (OWNER)
(813) 280-0202
Entity
Organization
Contact information
Practice address
2715 N MACDILL AVE, TAMPA, FL 33607-2205
(813) 280-0202
(813) 280-0203
Mailing address
PO BOX 4706, TAMPA, FL 33677-4706
(813) 280-0202
(813) 280-0203
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
PENDING
—
Enumeration date
01/05/2021
Last updated
01/05/2021
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