Individual
PUKHRAZ BASRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
(813) 745-4673
Mailing address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
(813) 745-4673
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
ME139834
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME139834
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN21919
FL
Other
Enumeration date
10/13/2015
Last updated
04/24/2019
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