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Individual

ANDY MOHAMMED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7509 CANAL BLVD, TAMPA, FL 33615-5605
(813) 453-2769
Mailing address
11794 CASA LAGO LN APT 102, TAMPA, FL 33626-1645
(813) 453-2769

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
03/10/2017
Last updated
03/10/2017
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