Individual
DR. MUTAZ B HABAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 W DR MARTIN LUTHER KING JR BLVD, SUITE 103, TAMPA, FL 33603-3600
(813) 238-0409
(813) 238-1119
Mailing address
205 W DR MARTIN LUTHER KING JR BLVD, SUITE 103, TAMPA, FL 33603-3600
(813) 238-0409
(813) 238-1119
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
ME21292
FL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
ME21292
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME21292
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01047
STAYWELL-WELLCARE-HEALTHEASE
FL
01
—
1247218
CIGNA
FL
01
—
202540
AMERIGROUP
FL
01
—
592023224
HUMANA
FL
01
—
68008
BLUE CROSS & BLUE SIHELD
FL
Enumeration date
10/02/2006
Last updated
05/15/2008
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