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Individual

GHIZLANE BOUZGHAR BAHIJ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2700 UNIVERSITY SQUARE DR, TAMPA, FL 33612-5513
(813) 253-2721
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036146236
IL
2085R0202X
Diagnostic Radiology Physician
Primary
139666
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103080700
FL
01
6DFIK
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/28/2012
Last updated
04/01/2021
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