Provider Demographics
NPI:1184651648
Name:ALASHTI, PARANDEH AMINI (PA)
Entity Type:Individual
Prefix:
First Name:PARANDEH
Middle Name:AMINI
Last Name:ALASHTI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 402808
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-0808
Mailing Address - Country:US
Mailing Address - Phone:305-695-0644
Mailing Address - Fax:305-695-0622
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:#2070
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-695-0644
Practice Address - Fax:305-695-0662
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3209363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE0719Medicare ID - Type Unspecified