Individual provider · NPI-1

Khadra S Ali-Mohamed, DO

Technician/Technologist, Optician · Tampa, FL

NPI number1992476857
StatusActive
Last updated in NPPESSep 21, 2021

Details

NPI
1992476857
Entity type
Individual (NPI-1)
Name
Khadra S Ali-Mohamed
Credential
DO
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 21, 2021
Certification date
Sep 15, 2021
Last updated
Sep 21, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, Optician7333FLYes

Practice location

10347 Cross Creek Blvd Ste C4
Tampa, FL 33647-2993

Phone 813-421-1453

Mailing address

10347 Cross Creek Blvd Ste C4
Tampa, FL 33647-2993

Phone 813-421-1453

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