Provider Demographics
NPI:1235758749
Name:FALASIRI, SEYED SHAYAN AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SEYED SHAYAN
Middle Name:AHMAD
Last Name:FALASIRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SEYED AHMAD
Other - Middle Name:SHAWIAN
Other - Last Name:FALASIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17 DAVIS BLVD. #308
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 DAVIS BLVD. #308
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606
Practice Address - Country:US
Practice Address - Phone:813-974-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN31620390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program