Organization
VISTA BEHAVIORAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD ALI MD (PRESIDENT)
(813) 390-7586
Entity
Organization
Contact information
Practice address
2718 LETAP CT UNIT 101, LAND O LAKES, FL 34638-7266
(813) 475-4196
(813) 475-4794
Mailing address
10607 CAYMAN ISLE CT, TAMPA, FL 33647-3372
(813) 390-7586
(813) 475-4794
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME98572
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001476800
—
FL
Enumeration date
11/05/2014
Last updated
05/19/2020
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