Provider Demographics
NPI:1407408586
Name:AHYA, PRIYA (AGACNP)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:AHYA
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 S UNIVERSITY DR STE 106
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3345
Mailing Address - Country:US
Mailing Address - Phone:954-723-0334
Mailing Address - Fax:
Practice Address - Street 1:3700 WASHINGTON ST STE 200
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8249
Practice Address - Country:US
Practice Address - Phone:954-894-3003
Practice Address - Fax:954-894-3323
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9292679207K00000X, 207R00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine