Organization
BAYSHORE MEDICAL GROUP P L
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YASHITALA AGZEW MD (MEMBER)
(813) 716-6959
Entity
Organization
Contact information
Practice address
19947 TAMIAMI AVE, TAMPA, FL 33647-3366
(813) 716-6959
Mailing address
19947 TAMIAMI AVE, TAMPA, FL 33647-3366
(813) 716-6959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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