Provider Demographics
NPI:1225477359
Name:AMIR, MAHSA (MD)
Entity Type:Individual
Prefix:
First Name:MAHSA
Middle Name:
Last Name:AMIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:303-318-2481
Practice Address - Street 1:9399 CROWN CREST BLVD STE 400
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8540
Practice Address - Country:US
Practice Address - Phone:303-840-3311
Practice Address - Fax:038-401-4733
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0058717207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology