Provider Demographics
NPI:1598857955
Name:YARAND, ANTHONY L (PA-C, MS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:L
Last Name:YARAND
Suffix:
Gender:M
Credentials:PA-C, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10954 SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-4701
Mailing Address - Country:US
Mailing Address - Phone:813-309-3088
Mailing Address - Fax:
Practice Address - Street 1:10954 SHELDON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4701
Practice Address - Country:US
Practice Address - Phone:813-309-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103935363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292744600Medicaid
FLAB454WMedicare PIN
Q76589Medicare UPIN