Individual
FARNAZ TABATABAIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME125109
FL
207R00000X
Internal Medicine Physician
ME125109
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015608000
—
FL
01
—
151N6
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/04/2010
Last updated
03/30/2021
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