Organization
SEASHORE RETINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD B TARABISHY MD (MANAGER)
(216) 235-7061
Entity
Organization
Contact information
Practice address
11031 US HIGHWAY 19, SUITE 106, PORT RICHEY, FL 34668-2213
(216) 235-7061
Mailing address
11031 US HIGHWAY 19, SUITE 106, PORT RICHEY, FL 34668-2213
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME117051
FL
Other
Enumeration date
05/23/2014
Last updated
05/23/2014
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