Individual
IMAD EDDEEN TARABISHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11339 CORTEZ BLVD, BROOKSVILLE, FL 34613-5404
(352) 596-8558
(352) 596-3494
Mailing address
11339 CORTEZ BLVD, BROOKSVILLE, FL 34613-5404
(352) 596-8558
(352) 596-3494
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME0044203
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26063
BCBS
FL
01
—
26063X
MEDICARE TYPE - UNSPECIFIED
FL
Enumeration date
08/16/2006
Last updated
06/27/2023
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