Provider Demographics
NPI:1952729543
Name:WASEF, PHILIP
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:WASEF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-972-2000
Mailing Address - Fax:
Practice Address - Street 1:350 E COMMERCIAL RD
Practice Address - Street 2:SUITE 112
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-4745
Practice Address - Country:US
Practice Address - Phone:480-999-8295
Practice Address - Fax:480-999-8295
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1282102084P0800X
CAC1919572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry