Provider Demographics
NPI:1598968901
Name:ALKHOURI, YAZAN HANI (MD)
Entity Type:Individual
Prefix:DR
First Name:YAZAN
Middle Name:HANI
Last Name:ALKHOURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 E 138TH AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3999
Mailing Address - Country:US
Mailing Address - Phone:813-975-2800
Mailing Address - Fax:813-977-7924
Practice Address - Street 1:3010 E 138TH AVE STE 12
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3999
Practice Address - Country:US
Practice Address - Phone:813-975-2800
Practice Address - Fax:813-977-7924
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2013-0552207RI0011X, 207RI0011X
NJ25MA09003900207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME152579OtherFL MD LICENSE
NMMD2013-0552OtherNM MD LICENSE