Provider Demographics
NPI:1275780520
Name:NOORANI, TABREZ Z (PA-C)
Entity Type:Individual
Prefix:
First Name:TABREZ
Middle Name:Z
Last Name:NOORANI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 BELL SHOALS RD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-7171
Mailing Address - Country:US
Mailing Address - Phone:813-571-1111
Mailing Address - Fax:813-571-1120
Practice Address - Street 1:4320 BELL SHOALS RD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-7171
Practice Address - Country:US
Practice Address - Phone:813-571-1111
Practice Address - Fax:813-571-1120
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105971363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9105971OtherLICENSE