Individual
BITA ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
6822 W WATERS AVE, TAMPA, FL 33634-2212
(813) 541-8734
Mailing address
121 HICKORY CREEK DR, BRANDON, FL 33511-8059
(813) 541-8734
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65921
BCBS
FL
Enumeration date
05/10/2006
Last updated
02/28/2018
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