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Provider Information for 1962451450

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

BITA ANSARI DPM

Gender: FEMALE

Individual NPI: 1962451450

Calendar   Last Updated:  2018-02-28
  Certification Date: 

Details

Name Value
NPI 1962451450
Enumeration Date 2006-05-10
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 121 HICKORY CREEK DR
BRANDON, FL 33511-8059
United States

Phone: 813-541-8734 | Fax:
View Map External Link
Primary Practice Address 6822 W WATERS AVE
TAMPA, FL 33634-2212
United States

Phone: 813-541-8734 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other BCBS FL 65921
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 213E00000X - Podiatrist FL PO3210