Individual
ALY-HUSSAIN JIWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13620 UNIVERSITY PLAZA ST, TAMPA, FL 33613-4649
(813) 462-4985
Mailing address
1325 BAY HARBOR DR APT 104, PALM HARBOR, FL 34685-3410
(781) 535-3185
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5919
FL
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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