Mutaz B Habal, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

ME21292 Issued in FL

Practice address

205 W Dr Martin Luther King Jr Blvd
Suite 103
Tampa, FL 33603-3600

Phone

(813) 238-0409

Fax

(813) 238-1119

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1801989017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W DR MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033600",
            "telephone_number": "813-238-0409",
            "fax_number": "813-238-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W DR MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033600",
            "telephone_number": "813-238-0409",
            "fax_number": "813-238-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABAL",
        "first_name": "MUTAZ",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME21292",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "FL",
            "license": "ME21292",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME21292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "202540",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "592023224",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SIHELD",
            "identifier": "68008",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL-WELLCARE-HEALTHEASE",
            "identifier": "01047",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1247218",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Joan Haas, ARNP
• Matthew Haas
• Melissa Haas, PA-C
• Shana Lynn Haas, LCSW
• Tia Marie Haas, APRN
• Miriam Esther Haban, P.T.A
• Habana Ambulatory Surgery Center LLC
• Habana Dental Care
• Habana Hospital Pharmacy Inc.
• Habana Medical Center

• Plastic and Reconstructive Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.