Provider Demographics
NPI:1841582772
Name:AREFAN-YAZDI, MAHSA (APRN)
Entity Type:Individual
Prefix:MISS
First Name:MAHSA
Middle Name:
Last Name:AREFAN-YAZDI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:519 E BLOOMINGDALE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8180
Mailing Address - Country:US
Mailing Address - Phone:727-771-7200
Mailing Address - Fax:727-216-1396
Practice Address - Street 1:2595 TAMPA RD
Practice Address - Street 2:SUITE P
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684
Practice Address - Country:US
Practice Address - Phone:727-771-7200
Practice Address - Fax:727-216-1396
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9205976363LF0000X
FLAPRN9205976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily